Healthcare Provider Details

I. General information

NPI: 1437513447
Provider Name (Legal Business Name): JESSICA ZHANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2016
Last Update Date: 06/13/2023
Certification Date: 06/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 S 320TH ST
FEDERAL WAY WA
98003-5200
US

IV. Provider business mailing address

90 STATE ST STE 700OFC40
ALBANY NY
12207-1716
US

V. Phone/Fax

Practice location:
  • Phone: 253-874-7000
  • Fax: 866-559-3952
Mailing address:
  • Phone: 408-762-5948
  • Fax: 408-762-5948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number0905477
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number303073
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number303073
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number174091
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: