MEDICARE: LUCY HWANG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD00041556	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0170800	OTHER	WA	L&I
3	250210	OTHER		INTERNAL ID-MOTOR VEHICLE ID

General Provider Information

NPI Number	:	1184709990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUCY HWANG

Provider Business Mailing Address
First Line	:	PO BOX 50095
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98145-5095
Country	:	US
Telephone Number	:	206-543-6420
Fax Number	:

Provider Business Practice Location Address
First Line	:	4915 25TH AVE NE STE 300W
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98105-5668
Country	:	US
Telephone Number	:	206-520-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	04/09/2014

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Directions to “ LUCY HWANG ” Practice Location

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