Individual
CHAYSEN CHONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
260 W HONEYSUCKLE AVE, HAYDEN, ID 83835-9270
(208) 762-0185
Mailing address
1011 E SHARPSBURG AVE APT 394, SPOKANE, WA 99208-6691
(808) 269-9412
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P8724
ID
Other
Enumeration date
12/21/2020
Last updated
12/21/2020
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