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NPI Code Detail

MEDICARE: DR. JEN-LIANG JACOB LIN M.D.

MEDICARE: DR. JEN-LIANG JACOB LIN M.D.
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
1207R00000XInternal Medicine Physician225097MA
2207RC0000XCardiovascular Disease Physician225097MA

General Provider Information

NPI Number : 1689648149
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEN-LIANG JACOB LIN M.D.
Provider Business Mailing Address
First Line : 12333 NE 130TH LN
Second Line : SUITE 320
City : KIRKLAND
State : WA
Zip : 98034-7467
Country : US
Telephone Number : 425-899-0555
Fax Number :
Provider Business Practice Location Address
First Line : 12333 NE 130TH LN
Second Line : SUITE 320
City : KIRKLAND
State : WA
Zip : 98034-7467
Country : US
Telephone Number : 425-899-0555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2006
Last Update Date : 03/10/2016

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