Basic Information
| Provider Information | |||||||||
| NPI: | 1568859825 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | YE | ||||||||
| FirstName: | FAN | ||||||||
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| Credential: | MD, MPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1215 LEE ST | ||||||||
| Address2: | BOX 800710 | ||||||||
| City: | CHARLOTTESVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 229080816 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4349820629 | ||||||||
| FaxNumber: | 4349820019 | ||||||||
| Practice Location | |||||||||
| Address1: | 1229 MADISON ST STE 1440 | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981043538 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2066250578 | ||||||||
| FaxNumber: | 2066259184 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2015 | ||||||||
| LastUpdateDate: | 07/29/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207L00000X | MD60932367 | WA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.