Healthcare Provider Details

I. General information

NPI: 1184545493
Provider Name (Legal Business Name): MICHAEL BINGCANG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5218 RIDGE DR NE
TACOMA WA
98422-1535
US

IV. Provider business mailing address

5218 RIDGE DR NE
TACOMA WA
98422-1535
US

V. Phone/Fax

Practice location:
  • Phone: 253-952-2768
  • Fax:
Mailing address:
  • Phone: 253-952-2768
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF05260556
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: