Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | MD60556923 | WA |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | MD60556923 | WA |
NPI | 1063689057 |
---|---|
Provider Name | Miss Luchin Fay Wong |
First Address | Seattle, WA 98104-3586 |
Second Address | Seattle, WA 98104-3586 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2008 |
Last Update Date | 16/02/2016 |