Provider Demographics
NPI:1275928392
Name:FONG, KATHRYN TRINH (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:TRINH
Last Name:FONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KATHRYN
Other - Middle Name:TRINH
Other - Last Name:RIMMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7320 216TH ST SW STE 310
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-8006
Mailing Address - Country:US
Mailing Address - Phone:425-673-3800
Mailing Address - Fax:469-242-9491
Practice Address - Street 1:7320 216TH ST SW STE 310
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-8006
Practice Address - Country:US
Practice Address - Phone:425-673-3800
Practice Address - Fax:469-242-9491
Is Sole Proprietor?:No
Enumeration Date:2015-04-06
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2984582084N0400X
WAMD611109762084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology