Healthcare Provider Details

I. General information

NPI: 1780766931
Provider Name (Legal Business Name): YU WANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 02/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16150 NE 85TH ST SUITE 109
REDMOND WA
98052-3539
US

IV. Provider business mailing address

16150 NE 85TH ST SUITE 109
REDMOND WA
98052-3539
US

V. Phone/Fax

Practice location:
  • Phone: 425-698-7436
  • Fax: 425-526-7288
Mailing address:
  • Phone: 425-698-7436
  • Fax: 425-526-7288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number5070
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5070
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD00048868
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number36919
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: