Individual
STACEY WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
319 S CEDAR ST, SPOKANE, WA 99201-7029
(509) 209-7429
Mailing address
16615 LARK AVE., SUITE 101, LOS GATOS, CA 95032
(408) 358-1460
(408) 358-1459
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
—
—
Other
Enumeration date
08/23/2017
Last updated
12/23/2019
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