Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH60555927 | WA |
N | 111NX0800X | Chiropractor Orthopedic Specialist | 687 | NM |
NPI | 1245351469 |
---|---|
Provider Name | Dr. Stephen W Kongs |
First Address | Bellingham, WA 98229-6264 |
Second Address | Bellingham, WA 98229-6264 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 08/12/2021 |