Healthcare Provider Details

I. General information

NPI: 1285416487
Provider Name (Legal Business Name): RUOXI WANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2023
Last Update Date: 10/23/2023
Certification Date: 10/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 112TH AVE NE STE 206
BELLEVUE WA
98004-3759
US

IV. Provider business mailing address

4233 9TH AVE NE APT 105
SEATTLE WA
98105-6042
US

V. Phone/Fax

Practice location:
  • Phone: 425-754-5135
  • Fax:
Mailing address:
  • Phone: 206-605-1087
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: