Reck, Penporn Vongsvivut
Reck, Penporn Vongsvivut is an individual health care provider with primary practice located at 345 College St Se Suite C, Lacey WA 98503-1014. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Reck, Penporn Vongsvivut can be contacted via phone (360) 456-3200.Contact Information
Primary practice address
345 College St Se Suite C
Lacey WA 98503-1014
Phone: (360) 456-3200
Fax: (360) 456-3894
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | MD00049407 | Washington |
Profile Details
| NPI number | 1811919871 |
|---|---|
| LBN Legal business name | Reck, Penporn Vongsvivut |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 25th, 2006 |
| Last updated | Nov 17th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811919871 | NPPES |
| Washington | MEDICAID | 8511552 |
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