Active NPI
Michael Wong
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Gresham, OR
National Provider Identifier
1538468889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 7760
- Practice address
- 1001 SW Highland Dr
Gresham, OR 97080-6354 - Phone
- (503) 674-7091
- NPI assigned
- Mar 24, 2011
- Last updated
- Mar 14, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 7760 | OR | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 7760 | OR | Primary |
Addresses
Primary practice location
1001 SW Highland Dr
Gresham, OR 97080-6354
Mailing address
1001 SW Highland Dr
Gresham, OR 97080-6354
Phone (503) 674-7091
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7760 | OR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1300924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457913600000",
"number": "1538468889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 SW HIGHLAND DR",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970806354",
"telephone_number": "503-674-7091"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 SW HIGHLAND DR",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970806354",
"telephone_number": "503-674-7091"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-03-24",
"last_updated": "2016-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "7760",
"primary": false
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "OR",
"license": "7760",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gresham, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.