Provider Demographics
NPI:1982372819
Name:TONG, ANHTHY (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANHTHY
Middle Name:
Last Name:TONG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:
Other - Last Name:TONG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1200 NW MARSHALL ST STE 1017
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-3177
Mailing Address - Country:US
Mailing Address - Phone:949-510-7006
Mailing Address - Fax:
Practice Address - Street 1:9205 SW BARNES RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6603
Practice Address - Country:US
Practice Address - Phone:503-216-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-03
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0018555183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist