Healthcare Provider Details

I. General information

NPI: 1346562816
Provider Name (Legal Business Name): SONG ZHAO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2010
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 MADISON ST STE 1020
SEATTLE WA
98104-1380
US

IV. Provider business mailing address

PO BOX 25608
SALT LAKE CITY UT
84125-0608
US

V. Phone/Fax

Practice location:
  • Phone: 206-386-9501
  • Fax: 206-386-9547
Mailing address:
  • Phone: 206-320-4476
  • Fax: 206-568-7043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberMD60147191
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: