Healthcare Provider Details

I. General information

NPI: 1306517297
Provider Name (Legal Business Name): JIE DENG, MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2021
Last Update Date: 09/22/2021
Certification Date: 09/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 116TH AVE NE STE 104
BELLEVUE WA
98004-3055
US

IV. Provider business mailing address

1600 116TH AVE NE STE 104
BELLEVUE WA
98004-3055
US

V. Phone/Fax

Practice location:
  • Phone: 425-454-5767
  • Fax: 833-559-1134
Mailing address:
  • Phone: 425-454-5767
  • Fax: 833-559-1134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number State

VIII. Authorized Official

Name: JIE DENG
Title or Position: MEDICAL DIRECTOR
Credential: MD, PHD
Phone: 425-454-5767