Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | MD60014822 | WA |
N | 207RX0202X | Medical Oncology | MD60014822 | WA |
NPI | 1154533412 |
---|---|
Provider Name | Dr. Junfeng Wang |
First Address | Mount Vernon, WA 98274-4100 |
Second Address | Mount Vernon, WA 98274 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 15/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2013054 | (05) | WA |