Provider Demographics
NPI:1255331377
Name:CHONG, DENNIS (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:
Last Name:CHONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3130 E MADISON ST
Mailing Address - Street 2:STE 205
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-4264
Mailing Address - Country:US
Mailing Address - Phone:206-329-2393
Mailing Address - Fax:206-329-9614
Practice Address - Street 1:500 17TH AVE
Practice Address - Street 2:WOUND HEALING CENTER
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5711
Practice Address - Country:US
Practice Address - Phone:206-320-2580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-29
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00037549208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation