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NPI Code Detail

MEDICARE: DR. DENNIS CHONG M.D.

MEDICARE: DR. DENNIS CHONG M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation PhysicianMD00037549WA

General Provider Information

NPI Number : 1255331377
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DENNIS CHONG M.D.
Provider Business Mailing Address
First Line : 3130 E MADISON ST
Second Line : STE 205
City : SEATTLE
State : WA
Zip : 98112-4264
Country : US
Telephone Number : 206-329-2393
Fax Number : 206-329-9614
Provider Business Practice Location Address
First Line : 500 17TH AVE
Second Line : WOUND HEALING CENTER
City : SEATTLE
State : WA
Zip : 98122-5711
Country : US
Telephone Number : 206-320-2580
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2005
Last Update Date : 02/04/2010

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