MEDICARE: DR. SAMUEL TONG D.C.

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	111N00000X	Chiropractor	00033812	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6421TO	OTHER	WA	REGENCE BLUESHIELD
2	0144667	OTHER	WA	DEPT OF LABOR & INDUSTRIE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	1905840	OTHER	WA	FIRST HEALTH
5	6047TO	OTHER	WA	REGENCE BLUESHIELD

General Provider Information

NPI Number	:	1851392674
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMUEL TONG D.C.

Provider Business Mailing Address
First Line	:	2206 QUEEN ANNE AVE N
Second Line	:	#201
City	:	SEATTLE
State	:	WA
Zip	:	98109-2370
Country	:	US
Telephone Number	:	206-378-5755
Fax Number	:	206-219-0556

Provider Business Practice Location Address
First Line	:	2206 QUEEN ANNE AVE N
Second Line	:	#201
City	:	SEATTLE
State	:	WA
Zip	:	98109-2370
Country	:	US
Telephone Number	:	206-378-5755
Fax Number	:	206-219-0556

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

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	12/07/2010

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Directions to “ DR. SAMUEL TONG D.C.” Practice Location

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