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Individual

ISAAC ANTON FONKEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1112 6TH AVE, 3-TFM, TACOMA, WA 98405-4040
(253) 792-6680
(253) 403-2915
Mailing address
1112 6TH AVE, TACOMA, WA 98405-4040
(253) 792-6680
(253) 403-2915

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
101180
MT
207Q00000X
Family Medicine Physician
Primary
MD.MD.61669853
WA

Other

Enumeration date
03/30/2018
Last updated
09/04/2025
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