MEDICARE: XU YANG

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1306168224
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	XU YANG

Provider Business Mailing Address
First Line	:	4139 12TH AVE NE
Second Line	:	#308
City	:	SEATTLE
State	:	WA
Zip	:	98105-6335
Country	:	US
Telephone Number	:	206-963-0436
Fax Number	:

Provider Business Practice Location Address
First Line	:	4139 12TH AVE NE
Second Line	:	#308
City	:	SEATTLE
State	:	WA
Zip	:	98105-6335
Country	:	US
Telephone Number	:	206-963-0436
Fax Number	:

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

Provider Enumeration Date	:	02/19/2010
Last Update Date	:	03/27/2010

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Directions to “ XU YANG ” Practice Location

Language	Start Address	Practice Location

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