Provider Demographics
NPI:1720229016
Name:CHUNG, UILANI KEALOHA (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:UILANI
Middle Name:KEALOHA
Last Name:CHUNG
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4722 143RD ST SE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98296-7648
Mailing Address - Country:US
Mailing Address - Phone:425-337-8861
Mailing Address - Fax:
Practice Address - Street 1:1355 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-2022
Practice Address - Country:US
Practice Address - Phone:360-794-4011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00002809235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist