Individual
SANGJAN RUNGRUANGKONKIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
325 9TH AVE, SEATTLE, WA 98104-2499
(206) 744-3000
Mailing address
325 9TH AVE, BOX 359797, SEATTLE, WA 98104-2499
(206) 744-9600
(206) 744-9920
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP30003912
WA
363LA2200X
Adult Health Nurse Practitioner
Primary
AP30003912
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02545U
REGENCE BLUE SHIELD PIN
WA
05
—
9618083
—
WA
Enumeration date
07/06/2006
Last updated
06/27/2011
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