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General NPI Number Information
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NPI Number | 1568520823
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Entity Type | Organization
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Legal Business Name | CHRISTINE NGOC M TANG
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1207 S JACKSON STREET SUITE #210
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City | SEATTLE
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State | WA
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Zip | 98144
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Country | US
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Telephone | 206-324-6843
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Fax |
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Provider Business Mailing Address
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Address Line | 24123 BEESON PLACE
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City | EDMONDS
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State | WA
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Zip | 98026
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Country | US
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Telephone | 206-324-6843
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTINE NGOC MY TANG
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Credential | DDS
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Telephone | 206-324-6843
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 6396
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License Number State | WA
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