Provider Demographics
NPI:1902070881
Name:WONG, HUNG (MA)
Entity Type:Individual
Prefix:
First Name:HUNG
Middle Name:
Last Name:WONG
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13667 SE TARALON DR
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-3618
Mailing Address - Country:US
Mailing Address - Phone:503-314-2128
Mailing Address - Fax:
Practice Address - Street 1:1675 WINTER ST NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-7152
Practice Address - Country:US
Practice Address - Phone:503-585-0351
Practice Address - Fax:503-585-0212
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-22
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health