Provider Demographics
NPI:1114960937
Name:HOU, PEN (MD)
Entity Type:Individual
Prefix:
First Name:PEN
Middle Name:
Last Name:HOU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17530 NE UNION HILL RD
Mailing Address - Street 2:STE 140
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3387
Mailing Address - Country:US
Mailing Address - Phone:425-310-6519
Mailing Address - Fax:425-968-9839
Practice Address - Street 1:17530 NE UNION HILL RD
Practice Address - Street 2:STE 140
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3387
Practice Address - Country:US
Practice Address - Phone:425-310-6519
Practice Address - Fax:425-968-9839
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00045554207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAP00614303OtherMEDICARE RAILROAD
WA8436446Medicaid
WAG8868467Medicare PIN
WAG8870826Medicare PIN
I45538Medicare UPIN