Active NPI
Stephen Wong, M.D.
- Allergy & Immunology Physician
- Tacoma, WA
National Provider Identifier
1740670728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy & Immunology Physician
- License
- 61479314
- Practice address
- 9040 Jackson Ave
Tacoma, WA 98431-0001 - Phone
- (253) 968-5422
- NPI assigned
- Jan 29, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | 61479314 | WA | Primary |
Addresses
Primary practice location
9040 Jackson Ave
Tacoma, WA 98431-0001
Mailing address
9040 Fitzsimmons Dr
Joint Base Lewis McChord, WA 98431-1000
Phone (253) 968-0208
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161103001280 | WA | Order and Referring Only - Internal Medicine | 5698053148 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61479314 | WA | MD | Allergy & Immunology Physician |
Interoperability endpoints
- swong797028@direct.multicare.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709251200000",
"number": "1740670728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9040 FITZSIMMONS DR",
"city": "JOINT BASE LEWIS MCCHORD",
"state": "WA",
"postal_code": "984311000",
"telephone_number": "253-968-0208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9040 JACKSON AVE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984310001",
"telephone_number": "253-968-5422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "STEPHEN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-01-29",
"last_updated": "2024-03-01",
"certification_date": "2024-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "WA",
"license": "61479314",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.