Provider Demographics
NPI:1174955785
Name:SUNGA, BYRON-NOEL VALDEZ (PT)
Entity type:Individual
Prefix:MR
First Name:BYRON-NOEL
Middle Name:VALDEZ
Last Name:SUNGA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 59565
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98058-2565
Mailing Address - Country:US
Mailing Address - Phone:206-335-0558
Mailing Address - Fax:
Practice Address - Street 1:3514 MORRIS AVE S
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5718
Practice Address - Country:US
Practice Address - Phone:206-335-0558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2021-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60953547225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist