Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | MD60706310 | WA |
NPI | 1083977557 |
---|---|
Provider Name | Dr. Melanie Hui Juan Chong |
First Address | Renton, WA 98057-4970 |
Second Address | Renton, WA 98055-5700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2012 |
Last Update Date | 19/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2069818 | (05) | WA |