Healthcare Provider Details

I. General information

NPI: 1306927975
Provider Name (Legal Business Name): ZHAO MING DONG M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 S COLUMBIAN WAY
SEATTLE WA
98108-1532
US

IV. Provider business mailing address

24853 SE 19TH ST
SAMMAMISH WA
98075-6078
US

V. Phone/Fax

Practice location:
  • Phone: 206-764-2264
  • Fax:
Mailing address:
  • Phone: 425-961-0159
  • Fax: 206-764-2001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License NumberMD00043776
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: