Provider Demographics
NPI:1164534244
Name:POUW, TIONG HIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:TIONG
Middle Name:HIAN
Last Name:POUW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:T HIAN
Other - Middle Name:
Other - Last Name:POUW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:403 F BLACK HILLS LN SW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502
Mailing Address - Country:US
Mailing Address - Phone:360-754-1676
Mailing Address - Fax:
Practice Address - Street 1:403 F BLACK HILLS LN SW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502
Practice Address - Country:US
Practice Address - Phone:360-754-1676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD14076207R00000X
WAMD00027940207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D72852Medicare UPIN