Healthcare Provider Details

I. General information

NPI: 1174411375
Provider Name (Legal Business Name): FEIYANG ZHUTANG DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2025
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8012 112TH STREET CT E STE 320
PUYALLUP WA
98373-7856
US

IV. Provider business mailing address

3008 PARKLANE DR NE
BREMERTON WA
98310-9725
US

V. Phone/Fax

Practice location:
  • Phone: 253-848-2331
  • Fax:
Mailing address:
  • Phone: 253-495-9465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number70008227
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: