Provider Demographics
NPI:1801669874
Name:DR PAUL DE JONG PLLC
Entity type:Organization
Organization Name:DR PAUL DE JONG PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:DE JONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-746-7167
Mailing Address - Street 1:414 GIRARD ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4004
Mailing Address - Country:US
Mailing Address - Phone:360-746-7167
Mailing Address - Fax:360-733-1165
Practice Address - Street 1:414 GIRARD ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4004
Practice Address - Country:US
Practice Address - Phone:360-746-7167
Practice Address - Fax:360-733-1165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-01
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty