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Individual

MATTHEW WONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
901 BOREN AVE, SUITE 711, SEATTLE, WA 98104-3595
(206) 622-6987
Mailing address
901 BOREN AVE, SUITE 711, SEATTLE, WA 98104-3595
(206) 622-6987

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1507409
WA
Enumeration date
10/16/2006
Last updated
04/21/2008
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