MEDICARE: DR. HELEN KUAN QUAN 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
1	208D00000X	General Practice Physician	MD00019716	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	63712	OTHER	WA	LABOR AND INDUSTRIES
2	4282309	OTHER		AETNA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	91943	OTHER		FIRST CHOICE
5	QU4050	OTHER	WA	REGENCE BLUESHIELD

General Provider Information

NPI Number	:	1922281419
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HELEN KUAN QUAN M.D.

Provider Business Mailing Address
First Line	:	6517 35TH AVE SW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98126-3005
Country	:	US
Telephone Number	:	206-937-1050
Fax Number	:	206-937-9590

Provider Business Practice Location Address
First Line	:	6517 35TH AVE SW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98126-3005
Country	:	US
Telephone Number	:	206-937-1050
Fax Number	:	206-937-9590

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

Provider Enumeration Date	:	12/07/2007
Last Update Date	:	02/15/2008

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