MEDICARE: WENSI SUN, MD, PS, INC

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	207W00000X	Ophthalmology Physician	MD00039922	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

General Provider Information

NPI Number	:	1336105006
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WENSI SUN, MD, PS, INC

Provider Business Mailing Address
First Line	:	11231 ROOSEVELT WAY NE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98125-6225
Country	:	US
Telephone Number	:	206-365-5800
Fax Number	:	206-364-2072

Provider Business Practice Location Address
First Line	:	11231 ROOSEVELT WAY NE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98125-6225
Country	:	US
Telephone Number	:	206-365-5800
Fax Number	:	206-364-2072

Authorized Official
Title or Position	:	PRESIDENT
Name	:	WENSI SUN
Credential	:	M.D., PH.D.
Telephone Number	:	206-365-5800

Provider Enumeration Date	:	04/21/2006
Last Update Date	:	06/25/2014

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