MEDICARE: TERRENCE C. WONG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0011X	Interventional Cardiology Physician	MD70043939	WA
2	207RI0011X	Interventional Cardiology Physician	G56275	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811047525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRENCE C. WONG MD

Provider Business Mailing Address
First Line	:	101 N MAIN ST
Second Line	:
City	:	COUPEVILLE
State	:	WA
Zip	:	98239-3413
Country	:	US
Telephone Number	:	360-678-7656
Fax Number	:

Provider Business Practice Location Address
First Line	:	275 SE CABOT DR STE B101
Second Line	:
City	:	OAK HARBOR
State	:	WA
Zip	:	98277-3740
Country	:	US
Telephone Number	:	360-246-4752
Fax Number	:	360-240-8350

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2007
Last Update Date	:	06/02/2026

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Directions to “ TERRENCE C. WONG MD” Practice Location

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