Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 68453341205 | UT |
Y | 207KA0200X | Allergist | MD60102678 | WA |
N | 2080P0201X | Pediatric Allergist | 46653 | WI |
NPI | 1770697112 |
---|---|
Provider Name | Dr. Marlene Peng |
First Address | Seattle, WA 98104-2120 |
Second Address | Seattle, WA 98104-2120 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2006 |
Last Update Date | 23/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0024PE | REGENCE (01) | WA |
256768 | LNI (01) | WA |
34622400 | (05) | WI |
8560427 | (05) | WA |