Provider Demographics
NPI:1942522206
Name:LUONG, HUNG CAN MICHAEL (LAC)
Entity Type:Individual
Prefix:
First Name:HUNG CAN
Middle Name:MICHAEL
Last Name:LUONG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:
Other - Last Name:LUONG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC
Mailing Address - Street 1:PO BOX 77710
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98177-0710
Mailing Address - Country:US
Mailing Address - Phone:206-659-8869
Mailing Address - Fax:
Practice Address - Street 1:4110 STONE WAY N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8000
Practice Address - Country:US
Practice Address - Phone:206-659-8869
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-26
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60116337171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist