Healthcare Provider Details

I. General information

NPI: 1073124160
Provider Name (Legal Business Name): MS. SHELIA POSHAN TSANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2020
Last Update Date: 08/12/2020
Certification Date: 08/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16033 SE FAIRWOOD BLVD
RENTON WA
98058-8639
US

IV. Provider business mailing address

16033 SE FAIRWOOD BLVD
RENTON WA
98058-8639
US

V. Phone/Fax

Practice location:
  • Phone: 206-234-9388
  • Fax:
Mailing address:
  • Phone: 206-234-9388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: