Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 60454602 | WA |
NPI | 1073541959 |
---|---|
Provider Name | Evan Ong |
First Address | Seattle, WA 98104-1360 |
Second Address | Seattle, WA 98104-1360 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 23/06/2021 |