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NPI Code Detail

MEDICARE: NATHAN PUNG

MEDICARE:   NATHAN  PUNG
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
12085R0205XRadiological Physics Physician233CO

General Provider Information

NPI Number : 1417888538
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATHAN PUNG
Provider Business Mailing Address
First Line : 6510 S DEVONSHIRE CT
Second Line :
City : SPOKANE
State : WA
Zip : 99223-6230
Country : US
Telephone Number : 719-210-3435
Fax Number :
Provider Business Practice Location Address
First Line : 6510 S DEVONSHIRE CT
Second Line :
City : SPOKANE
State : WA
Zip : 99223-6230
Country : US
Telephone Number : 719-210-3435
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2026
Last Update Date : 05/27/2026

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Directions to “ NATHAN PUNG ” Practice Location

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