Provider Demographics
NPI:1184641904
Name:CHEUNG, ADA (MD)
Entity Type:Individual
Prefix:
First Name:ADA
Middle Name:
Last Name:CHEUNG
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 1:121 N DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98001
Mailing Address - Country:US
Mailing Address - Phone:253-218-4940
Mailing Address - Fax:253-833-1071
Practice Address - Street 1:121 N DIVISION ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98001
Practice Address - Country:US
Practice Address - Phone:253-218-4940
Practice Address - Fax:253-833-1071
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101235527207X00000X
WAMD60149417207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10306426Medicaid
VA017986C18Medicare PIN
VAG65321Medicare UPIN
010928C40Medicare PIN