Healthcare Provider Details

I. General information

NPI: 1053103234
Provider Name (Legal Business Name): EG BIOMED US INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2025
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21720 23RD DR SE STE 275
BOTHELL WA
98021-3912
US

IV. Provider business mailing address

21720 23RD DR SE STE 275
BOTHELL WA
98021-3912
US

V. Phone/Fax

Practice location:
  • Phone: 206-888-0858
  • Fax:
Mailing address:
  • Phone: 206-888-0858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: RUO-KAI LIN
Title or Position: CHIEF OF R & D
Credential: PHD
Phone: 206-888-0858