Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | DE60160952 | WA |
NPI | 1093007569 |
---|---|
Provider Name | Dr. Yi-Ming Yang |
First Address | Federal Way, WA 98003-8505 |
Second Address | Federal Way, WA 98003-8505 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2011 |
Last Update Date | 03/05/2011 |