Healthcare Provider Details

I. General information

NPI: 1285478354
Provider Name (Legal Business Name): TONG LAW RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2024
Last Update Date: 06/22/2024
Certification Date: 06/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST
SEATTLE WA
98195-0001
US

IV. Provider business mailing address

5720 26TH AVE NE
SEATTLE WA
98105-5506
US

V. Phone/Fax

Practice location:
  • Phone: 206-598-6004
  • Fax:
Mailing address:
  • Phone: 206-743-7748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number60240263
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: