Provider Demographics
NPI:1689659252
Name:CHONG, BOO-KHEAT (PHARM D)
Entity Type:Individual
Prefix:MR
First Name:BOO-KHEAT
Middle Name:
Last Name:CHONG
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 1:211 S 48TH ST
Mailing Address - Street 2:UNIT A
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-7983
Mailing Address - Country:US
Mailing Address - Phone:206-658-7105
Mailing Address - Fax:
Practice Address - Street 1:4700 NE 4TH ST
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98059-4800
Practice Address - Country:US
Practice Address - Phone:425-793-1015
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH39674183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist