Provider Demographics
NPI:1467789743
Name:HONG, HAI VIET (DAOM, LAC)
Entity Type:Individual
Prefix:
First Name:HAI
Middle Name:VIET
Last Name:HONG
Suffix:
Gender:M
Credentials:DAOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 117TH PL SE UNIT A
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-4949
Mailing Address - Country:US
Mailing Address - Phone:425-353-4524
Mailing Address - Fax:
Practice Address - Street 1:11611 AIRPORT ROAD, SUITE 205
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204
Practice Address - Country:US
Practice Address - Phone:206-240-3597
Practice Address - Fax:425-353-4524
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-07
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60071800171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist