Basic Information
| Provider Information | |||||||||
| NPI: | 1689861536 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHERPA | ||||||||
| FirstName: | NAWANG | ||||||||
| MiddleName: | KARSANG | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 30809 1ST AVE S | ||||||||
| Address2: | |||||||||
| City: | FEDERAL WAY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980034074 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2538392030 | ||||||||
| FaxNumber: | 2538391071 | ||||||||
| Practice Location | |||||||||
| Address1: | 30809 1ST AVE S | ||||||||
| Address2: | |||||||||
| City: | FEDERAL WAY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980034074 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2538392030 | ||||||||
| FaxNumber: | 2538391071 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/25/2007 | ||||||||
| LastUpdateDate: | 08/12/2011 | ||||||||
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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 | 207Q00000X | ML20008076 | WA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 8500712 | 05 | WA | MEDICAID | 0280256 | 01 | WA | STATE L&I | OTHER |