1033403290 NPI number — MS. SHWU YNG CHOONG RPH

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033403290 NPI number — MS. SHWU YNG CHOONG RPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHOONG
Provider First Name:
SHWU
Provider Middle Name:
YNG
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
RPH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033403290
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/06/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4575 W 11TH AVE
Provider Second Line Business Mailing Address:
T-1405
Provider Business Mailing Address City Name:
EUGENE
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97402-5442
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-684-4589
Provider Business Mailing Address Fax Number:
541-684-4589

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4575 W 11TH AVE
Provider Second Line Business Practice Location Address:
T-1405
Provider Business Practice Location Address City Name:
EUGENE
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97402-5442
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-684-4589
Provider Business Practice Location Address Fax Number:
541-684-4589
Provider Enumeration Date:
06/06/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  RPH0008374 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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