Individual
JOHNNY VONGVILAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1600 N 20TH AVE STE A, PASCO, WA 99301-3376
(509) 537-3025
Mailing address
18600 SE MCLOUGHLIN BLVD, MILWAUKIE, OR 97267-6723
(971) 255-0658
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
WA
Other
Enumeration date
01/08/2025
Last updated
01/08/2025
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