Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | MD60069605 | WA |
Y | 207XS0117X | Orthopaedic Spine Surgeon | MD60069605 | WA |
NPI | 1144392606 |
---|---|
Provider Name | Dr. Andelle Teng |
First Address | Auburn, WA 98002-4013 |
Second Address | Auburn, WA 98002-4013 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 14/02/2020 |