Basic Information
| Provider Information | |||||||||
| NPI: | 1376651331 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | YANG | ||||||||
| FirstName: | PING | ||||||||
| MiddleName: | JIAN WONG | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | AC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3007 | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981143007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2067883642 | ||||||||
| FaxNumber: | 2066525216 | ||||||||
| Practice Location | |||||||||
| Address1: | 720 8TH AVE S | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981043032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2067883734 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2006 | ||||||||
| LastUpdateDate: | 10/26/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171100000X | AC00000202 | WA | Y | Other Service Providers | Acupuncturist |
ID Information
| ID | Type | State | Issuer | Description | WOO154 | 01 | REGENCE BLUESHIELD | OTHER | 5841617 | 01 | AETNA | OTHER |