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Individual

MR. JASON TRUONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
10412 264TH ST E, GRAHAM, WA 98338-8706
(253) 683-8600
Mailing address
5610 S 235TH ST, APT. FF202, KENT, WA 98032-3761
(503) 568-4244

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT60562637
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
341776
NBCOT OTR CERTIFICATION
Enumeration date
08/04/2015
Last updated
08/04/2015
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