Provider Demographics
NPI:1275642779
Name:CHUNG, GARY WHAKUK (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:WHAKUK
Last Name:CHUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:34719 6TH AVE S
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-8714
Mailing Address - Country:US
Mailing Address - Phone:206-212-2100
Mailing Address - Fax:206-212-2194
Practice Address - Street 1:34719 6TH AVE S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-8714
Practice Address - Country:US
Practice Address - Phone:206-212-2100
Practice Address - Fax:206-212-2194
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00045207207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA91162803298003A010OtherTRICARE/WPS FEDERAL WAY #
WAP00236905OtherRAILROAD MEDICARE IND #
WA0198407OtherL&I INDIVIDUAL NUMBER
WA337240500OtherUS POSTAL SERVICE
WA91162803298116A006OtherTRICARE/WPS BURIEN #
WA0059460OtherL&I GROUP NUMBER
WA0095CHOtherREGENCE FEDERAL WAY RYDER
WA91162803298002A009OtherTRICARE/WPS AUBURN #
WACD6646OtherRAILROAD MEDICARE GROUP #
WA891451OtherCRIME VICTIMS GROUP NUMBE
WAEV8144OtherREGENCE GROUP NUMBER
WA4973CHOtherREGENCE BURIEN RYDER
WA8428716Medicaid
WA7929CHOtherREGENCE AUBURN RYDER #
WA8428716OtherCHPW GAU (DSHS) NUMBER
WA911628032OtherBLUE CROSS PREMERA
WACD6646OtherRAILROAD MEDICARE GROUP #
WA7080781Medicaid
WA337240500OtherUS POSTAL SERVICE
WA7929CHOtherREGENCE AUBURN RYDER #