Provider Demographics
NPI:1194072876
Name:HONG, GAYOUNG (MD)
Entity type:Individual
Prefix:
First Name:GAYOUNG
Middle Name:
Last Name:HONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 POWELL AVE SW
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057
Mailing Address - Country:US
Mailing Address - Phone:425-277-1311
Mailing Address - Fax:
Practice Address - Street 1:403 E MEEKER ST
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-5904
Practice Address - Country:US
Practice Address - Phone:253-852-2866
Practice Address - Fax:253-852-3102
Is Sole Proprietor?:No
Enumeration Date:2012-08-13
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60536682207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000211956AMedicaid
GA000211956CMedicaid
GA111907Medicare Oscar/Certification
GA111960Medicare Oscar/Certification
GA000211956CMedicaid