Individual ProviderMikyung ChungNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address1100 9th Ave, Seattle, WA 98101-2756(206) 223-6600(206) 515-5811PECOS EnrollmentBased on the most recent information from CMS, provider Mikyung Chung does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1104147289Provider TypeIndividualFull NameChung, MikyungCredentialCRNAGenderFemaleSole ProprietorNoEnumeration Date6/12/2010Last Updated5/10/2018Contact InformationPractice LocationPractice Address1100 9th Ave, Seattle, WA 98101-2756Phone(206) 223-6600FaxUnlisted FaxMailing LocationMailing Address1100 9th Ave, M4-Pfs, Seattle, WA 98101-2756Phone(206) 515-5811Fax(206) 341-0274Provider TaxonomiesCodeDescriptionLicenseCode367500000XPrimaryDescriptionNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAP60821954WashingtonCode367500000XDescriptionNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersLicenseL6-0A00675DelawareProvider IdentifiersIDDescriptionIssuerID1104147289DescriptionMedicaidIssuerUnlistedDelaware