Healthcare Provider Details

I. General information

NPI: 1831500362
Provider Name (Legal Business Name): TAWNY HUNG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2014
Last Update Date: 08/08/2024
Certification Date: 08/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1703 S MERIDIAN STE 101
PUYALLUP WA
98371-7590
US

IV. Provider business mailing address

1703 S MERIDIAN STE 101
PUYALLUP WA
98371-7590
US

V. Phone/Fax

Practice location:
  • Phone: 253-446-3904
  • Fax:
Mailing address:
  • Phone: 253-446-3904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License NumberMD61514271
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License NumberMD61514271
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: