Ly Pong

NPI #1255740700 in Happy Valley, Oregon

Provider Information

NPI Number: 1255740700
Entity Type: Individual
Name: Ly Pong
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Enumeration Date: Aug 8, 2014
Last Updated: Aug 8, 2014

Practice Location

Address: 10000 SE 82ND AVE
City: Happy Valley
State: Oregon
ZIP Code: 97086-2304
Phone: (503) 788-4757

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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