Individual provider · Type 1 NPI

Phong Ly, PA-C

Medical Physician Assistant · Portland, OR

NPI number 1467235135 Active

Practice location

3303 S Bond Ave
Portland, OR 97239-4501

Call (503) 494-7246 Map

Mailing address

3181 SW Sam Jackson Park Rd, Mail Code SJH-2
Portland, OR 97239

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000XNone listed
Medical Physician Assistant Primary 363AM0700XPA218098 (OR)

Medical Physician Assistant: Definition to come...

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About NPI 1467235135

Phong Ly, PA-C's National Provider Identifier is 1467235135, issued on Aug 16, 2023. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Portland, OR. The record was last updated on Dec 19, 2023.