Provider Demographics
NPI:1245351469
Name:KONGS, STEPHEN W (DC)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:W
Last Name:KONGS
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 1:1420 KING ST STE D
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-6264
Mailing Address - Country:US
Mailing Address - Phone:360-676-4488
Mailing Address - Fax:360-647-5587
Practice Address - Street 1:1420 KING ST STE D
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229-6264
Practice Address - Country:US
Practice Address - Phone:360-676-4488
Practice Address - Fax:360-647-5587
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM687111NX0800X
WACH60555927111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM2672478Medicare ID - Type Unspecified