Individual
MR. HENRY BUN LOK FONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D
Contact information
Practice address
10302 156TH ST E, PUYALLUP, WA 98374-9321
(253) 604-1067
(253) 604-1077
Mailing address
10302 156TH ST E, PUYALLUP, WA 98374-9321
(253) 604-1067
(253) 604-1077
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH60162018
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH60162018
STATE LICENSE
WA
Enumeration date
06/16/2011
Last updated
06/16/2011
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