Individual
IRENE W CHONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
2121 NE 139TH ST, VANCOUVER, WA 98686-2316
(360) 487-1777
(360) 487-1779
Mailing address
PO BOX 2077, PORTLAND, OR 97208-2077
(503) 413-3900
(503) 413-1860
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL60002764
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
WA
Enumeration date
10/02/2008
Last updated
10/02/2008
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