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1366023541
ROUSSELL WONG
SEATTLE, WA
NPI
1366023541
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2021-04-19
Last Update Date
2021-05-10
Business Address
ROUSSELL WONG SUDP-T
113 23RD AVE S
SEATTLE, WA 98144-2309
Phone number: 206-219-5980
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Mailing Address
ROUSSELL WONG SUDP-T
113 23RD AVE S
SEATTLE, WA 98144-2309
Phone number: 206-822-8066
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