Healthcare Provider Details

I. General information

NPI: 1902326614
Provider Name (Legal Business Name): BIWEI DONG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2017
Last Update Date: 06/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18022 68TH AVE NE
KENMORE WA
98028-2400
US

IV. Provider business mailing address

9 GREENWAY PLZ STE 2950
HOUSTON TX
77046-0924
US

V. Phone/Fax

Practice location:
  • Phone: 425-424-2320
  • Fax: 425-481-1747
Mailing address:
  • Phone: 713-335-1733
  • Fax: 713-491-4677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60769407
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: