Provider Demographics
NPI:1679179493
Name:CHON, PAUL M (PHARM D)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:M
Last Name:CHON
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1929 QUEEN ANNE AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-2549
Mailing Address - Country:US
Mailing Address - Phone:206-285-1737
Mailing Address - Fax:206-285-1791
Practice Address - Street 1:1929 QUEEN ANNE AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-2549
Practice Address - Country:US
Practice Address - Phone:206-285-1737
Practice Address - Fax:206-285-1791
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-07
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH61129050183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist