Healthcare Provider Details

I. General information

NPI: 1558964585
Provider Name (Legal Business Name): CHRIS HONG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2020
Last Update Date: 07/23/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 BROADWAY STE 114
SEATTLE WA
98122-5330
US

IV. Provider business mailing address

601 BROADWAY STE 114
SEATTLE WA
98122-5330
US

V. Phone/Fax

Practice location:
  • Phone: 206-215-3878
  • Fax:
Mailing address:
  • Phone: 206-215-3878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberPH61066433
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: