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General NPI Number Information
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NPI Number | 1700029600
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Entity Type | Organization
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Legal Business Name | THOMAS TAI CHUNG MD PLLC
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Dates
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Enumeration Date | 04/08/2009
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Last Update Date | 04/08/2009
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Provider Practice Location Address
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Address Line | 1600 E JEFFERSON ST SUITE 620
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City | SEATTLE
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State | WA
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Zip | 98122-5698
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Country | US
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Telephone | 206-320-2675
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Fax | 206-320-4302
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Provider Business Mailing Address
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Address Line | 1600 E JEFFERSON ST SUITE 620
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City | SEATTLE
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State | WA
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Zip | 98122-5698
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Country | US
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Telephone | 206-320-2675
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Fax | 206-320-4302
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Authorized Official
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Title or Position | OWNER/SOLE MEMBER
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Name | THOMAS TAI CHUNG
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Credential | MD
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Telephone | 206-320-2675
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | MD00038197
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License Number State | WA
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