Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | AP60592750 | WA |
Y | 363LP2300X | Nurse Practitioner - Primary Care | AP60592750 | WA |
NPI | 1033586532 |
---|---|
Provider Name | Christopher Duong |
First Address | Federal Way, WA 98003-6022 |
Second Address | Federal Way, WA 98003-6022 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2015 |
Last Update Date | 31/08/2015 |