Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 273434 | OR |
N | 111NR0400X | Rehabilitation Chiropractor | 60127216 | WA |
NPI | 1013090067 |
---|---|
Provider Name | Dr. Wesley F Poon |
First Address | Portland, OR 97204-2405 |
Second Address | Portland, OR 97204-2405 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2006 |
Last Update Date | 16/06/2014 |