Individual
STACEY GUO CHONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8821 NE 5TH ST, VANCOUVER, WA 98664
(360) 514-2340
(360) 514-2345
Mailing address
505 NE 87TH AVE STE 460, VANCOUVER, WA 98664-1965
(360) 514-2340
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
A176604
CA
207RR0500X
Rheumatology Physician
Primary
MD61483707
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/30/2019
Last updated
10/01/2024
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