Basic Information
Provider Information
NPI: 1851379994
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LIN
FirstName: WEI-HSUNG
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3900 S ZINTEL WAY
Address2:  
City: KENNEWICK
State: WA
PostalCode: 99338
CountryCode: US
TelephoneNumber: 5099423627
FaxNumber: 5099422268
Practice Location
Address1: 3950 KEENE RD
Address2:  
City: WEST RICHLAND
State: WA
PostalCode: 993534901
CountryCode: US
TelephoneNumber: 5099423130
FaxNumber: 5096288335
Other Information
ProviderEnumerationDate: 01/09/2006
LastUpdateDate: 11/11/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/11/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XMD20067ORN Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000XMD60207016WAY Allopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
028412201WAL&IOTHER
028412201WALABOR & INDUSTRIESOTHER


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