Individual
DR. SUWONG WONGSUWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 W POPLAR ST, ST MARY MEDICAL CENTER, CARDIOLOGY SUITE, WALLA WALLA, WA 99362-2846
(509) 897-2600
(509) 897-5747
Mailing address
PO BOX 32, LIBERTY LAKE, WA 99019-0032
(509) 897-2600
(509) 897-5747
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD00039949
WA
207RC0000X
Cardiovascular Disease Physician
MD39949
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1011703
—
WA
05
—
288534
—
OR
05
—
806100200
—
ID
Enumeration date
05/23/2006
Last updated
08/12/2025
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