Provider Demographics
NPI:1659997625
Name:AGUIRRE-WONG, NEENAH CORINNE (DPM)
Entity Type:Individual
Prefix:
First Name:NEENAH
Middle Name:CORINNE
Last Name:AGUIRRE-WONG
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9055 SW 73RD CT APT 2404
Mailing Address - Street 2:
Mailing Address - City:PINECREST
Mailing Address - State:FL
Mailing Address - Zip Code:33156-2959
Mailing Address - Country:US
Mailing Address - Phone:305-401-9413
Mailing Address - Fax:
Practice Address - Street 1:34509 9TH AVE S STE 306
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-8710
Practice Address - Country:US
Practice Address - Phone:253-229-1058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program