Healthcare Provider Details

I. General information

NPI: 1356601553
Provider Name (Legal Business Name): CONNIE U YEUNG DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2012
Last Update Date: 07/26/2023
Certification Date: 07/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12040 NE 128TH ST
KIRKLAND WA
98034-3013
US

IV. Provider business mailing address

12040 NE 128TH ST MS-50
KIRKLAND WA
98034-3013
US

V. Phone/Fax

Practice location:
  • Phone: 425-899-1000
  • Fax: 484-345-2393
Mailing address:
  • Phone: 425-899-1920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number20A14825
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberOP61169166
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: