MEDICARE: CHRISTOPHER GIA HOANG

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	208100000X	Physical Medicine & Rehabilitation Physician	61470392	WA

General Provider Information

NPI Number	:	1629751003
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER GIA HOANG

Provider Business Mailing Address
First Line	:	1916 S 374TH PL
Second Line	:
City	:	FEDERAL WAY
State	:	WA
Zip	:	98003-7558
Country	:	US
Telephone Number	:	253-326-0915
Fax Number	:

Provider Business Practice Location Address
First Line	:	1010 S 336TH ST STE 112
Second Line	:
City	:	FEDERAL WAY
State	:	WA
Zip	:	98003-7355
Country	:	US
Telephone Number	:	253-466-6017
Fax Number	:

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

Provider Enumeration Date	:	08/10/2023
Last Update Date	:	08/10/2023

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