Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | AP60610992 | WA |
Y | 363LG0600X | Nurse Practitioner - Gerontology | AP60610992 | WA |
NPI | 1033591235 |
---|---|
Provider Name | Chantel Yuong |
First Address | University Place, WA 98466-4614 |
Second Address | University Place, WA 98466-4614 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2015 |
Last Update Date | 19/01/2021 |