PHANTHABOON J PHANNAVONG

SEATTLE, WA
NPI1831850791
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: WA  PA61358368)
Enumeration Date2022-01-04
Last Update Date2026-02-10
Business Address
PHANTHABOON J PHANNAVONG PA-C
825 EASTLAKE AVE E
SEATTLE, WA 98109-4405
Phone number: 206-520-5000
Mailing Address
PHANTHABOON J PHANNAVONG PA-C
PO BOX 50095
SEATTLE, WA 98145-5095
Phone number: 206-520-5700
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