Organization
MID-COLUMBIA EAR, NOSE & THROAT, P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL SCOTT FONG M.D. (OWNER)
(509) 585-0795
Entity
Organization
Contact information
Practice address
3903 S IRBY ST, KENNEWICK, WA 99337-2451
(509) 585-0795
Mailing address
3903 S IRBY ST, KENNEWICK, WA 99337-2451
(509) 585-0795
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD00032458
WA
231H00000X
Audiologist
LD0002175
WA
Other
Enumeration date
04/26/2008
Last updated
05/10/2008
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