Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | MD00046263 | WA |
NPI | 1104845668 |
---|---|
Provider Name | John C Hung |
First Address | Puyallup, WA 98372-4602 |
Second Address | Puyallup, WA 98372-4602 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 09/04/2012 |