Provider Demographics
NPI:1851392674
Name:TONG, SAMUEL (DC)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:
Last Name:TONG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2206 QUEEN ANNE AVE N
Mailing Address - Street 2:#201
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-2370
Mailing Address - Country:US
Mailing Address - Phone:206-378-5755
Mailing Address - Fax:206-219-0556
Practice Address - Street 1:2206 QUEEN ANNE AVE N
Practice Address - Street 2:#201
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-2370
Practice Address - Country:US
Practice Address - Phone:206-378-5755
Practice Address - Fax:206-219-0556
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00033812111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA6421TOOtherREGENCE BLUESHIELD
WA0144667OtherDEPT OF LABOR & INDUSTRIE
WA8349755Medicaid
WA1905840OtherFIRST HEALTH
WA6047TOOtherREGENCE BLUESHIELD
WA8349755Medicaid
WA6047TOOtherREGENCE BLUESHIELD