Provider Demographics
NPI:1124192307
Name:HWANG, IRENE (MD)
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:
Last Name:HWANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3633 136TH PLACE SE
Mailing Address - Street 2:SUITE #110
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3633 136TH PLACE SE
Practice Address - Street 2:SUITE #110
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006
Practice Address - Country:US
Practice Address - Phone:425-747-7202
Practice Address - Fax:425-643-0635
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00043208208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics