Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Soohan Bong

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1710591821

Soohan Bong is a Physician Assistant in Portland, Oregon. Qualified in 2021, 5 years ago. Practices with The Oregon Clinic, PC, a 352-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Oregon.

Years since qualifying
5
Licensed in
OR
In the registry since
2020
Specialties on file
2
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

5050 NE Hoyt St Ste 359
Portland, OR 97213-2983
Phone: (503) 935-8501
Fax: (503) 935-8506
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 9155 Sw Barnes Rd Ste 440, Portland, OR 97225-6631 — (503) 935-8500

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA207120 (OR)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (OR)

Record details

NPI number1710591821
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 4, 2020
Last updated in NPPESFebruary 7, 2023
Certification dateOctober 12, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice The Oregon Clinic, Pc — 352 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

Other providers in Portland