Healthcare Provider Details

I. General information

NPI: 1750031498
Provider Name (Legal Business Name): PRISCILLA YONG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2022
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1530 S UNION AVE STE 1
TACOMA WA
98405-1954
US

IV. Provider business mailing address

PO BOX 5299 MS: 820-5-PCO
TACOMA WA
98415-0299
US

V. Phone/Fax

Practice location:
  • Phone: 253-301-5300
  • Fax: 253-752-6073
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD70012595
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: