Healthcare Provider Details

I. General information

NPI: 1164775508
Provider Name (Legal Business Name): HOANG H DANG, MD, PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2012
Last Update Date: 07/20/2023
Certification Date: 07/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3955 156TH ST NE
MARYSVILLE WA
98271-4831
US

IV. Provider business mailing address

3138 108TH AVE SE
BELLEVUE WA
98004-7414
US

V. Phone/Fax

Practice location:
  • Phone: 425-505-7263
  • Fax:
Mailing address:
  • Phone: 425-505-7260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: HOANG HUY DANG
Title or Position: PRESIDENT
Credential: MD
Phone: 425-505-7260