Provider Demographics
NPI:1023378585
Name:NG, PETER TSUNG-KIN (RPH)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:TSUNG-KIN
Last Name:NG
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 TERRACE AVE
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-3036
Mailing Address - Country:US
Mailing Address - Phone:503-657-9422
Mailing Address - Fax:
Practice Address - Street 1:16246 SE MCLOUGHLIN BLVD
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97267-4657
Practice Address - Country:US
Practice Address - Phone:503-657-9422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-17
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0005846183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist