Individual
PORNCHANOK TAM KHEOCHA-ON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3800 RESERVOIR RD NW, WASHINGTON, DC 20007-2113
(202) 444-2000
Mailing address
6291 HILLARY CT, ALEXANDRIA, VA 22315-3440
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
NP1041368
DC
363LF0000X
Family Nurse Practitioner
Primary
NP1041368
DC
Other
Enumeration date
12/20/2022
Last updated
02/22/2023
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