Individual
AME PHITWONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
21727 76TH AVE W STE H, EDMONDS, WA 98026-7549
(425) 672-1333
(425) 672-7755
Mailing address
21727 76TH AVE W STE H, EDMONDS, WA 98026-7549
(425) 672-1333
(425) 672-7755
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
AP60791082
WA
363L00000X
Nurse Practitioner
AP60791082
WA
Other
Enumeration date
08/29/2017
Last updated
02/26/2020
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