Individual
KONG CHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13617 109TH STREET CT E, PUYALLUP, WA 98374-5607
(253) 445-4329
Mailing address
13617 109TH STREET CT E, PUYALLUP, WA 98374-5607
(253) 445-4329
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
750304
WA
Other
Enumeration date
05/17/2022
Last updated
05/17/2022
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