Healthcare Provider Details

I. General information

NPI: 1811047525
Provider Name (Legal Business Name): TERRENCE C. WONG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 SE CABOT DR STE B101
OAK HARBOR WA
98277-3740
US

IV. Provider business mailing address

101 N MAIN ST
COUPEVILLE WA
98239-3413
US

V. Phone/Fax

Practice location:
  • Phone: 360-246-4752
  • Fax: 360-240-8350
Mailing address:
  • Phone: 360-678-7656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberMD70043939
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberG56275
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: