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1346448388

NPI Code Detail

MEDICARE: BONNIE KEUNG MD

MEDICARE: BONNIE KEUNG MD

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
1	207W00000X	Ophthalmology Physician	MD60569672	WA
2	2084N0400X	Neurology Physician	MD60569672	WA
3	207WX0109X	Neuro-ophthalmology Physician	MD60569672	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346448388
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BONNIE KEUNG MD

Provider Business Mailing Address
First Line	:	PO BOX 25608
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84125-0608
Country	:	US
Telephone Number	:	206-320-4476
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 17TH AVE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98122-5711
Country	:	US
Telephone Number	:	206-320-2800
Fax Number	:	206-320-2827

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2007
Last Update Date	:	03/13/2026

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Directions to “ BONNIE KEUNG MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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