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General NPI Number Information
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NPI Number | 1053499608
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Entity Type | Individual
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Provider Name | KATHY I-WEN WANG DO
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Gender | Female
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 06/30/2009
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Provider Practice Location Address
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Address Line | 1519 3RD ST SE STE 101
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City | PUYALLUP
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State | WA
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Zip | 98372-3742
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Country | US
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Telephone | 253-841-8939
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Fax | 253-841-5944
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Provider Business Mailing Address
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Address Line | PO BOX 84125
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City | SEATTLE
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State | WA
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Zip | 98124-5425
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Country | US
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Telephone | 253-841-8939
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Fax | 253-841-5944
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | OP00002056
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 20A9456
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 220817
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | OP00002056
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License Number State | WA
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