Healthcare Provider Details

I. General information

NPI: 1699465179
Provider Name (Legal Business Name): JONATHAN H DANG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2023
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 COLBY AVE STE B400
EVERETT WA
98201-1665
US

IV. Provider business mailing address

1321 COLBY AVE STE B400
EVERETT WA
98201-1665
US

V. Phone/Fax

Practice location:
  • Phone: 425-297-5234
  • Fax:
Mailing address:
  • Phone: 206-553-9569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD.MD.70125227
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: