Individual
CASSANDRA M WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
747 BROADWAY, SEATTLE, WA 98122-4379
(206) 215-2520
(206) 215-6364
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA61155830
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619495991
—
WA
Enumeration date
09/06/2017
Last updated
08/09/2021
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