Provider Demographics
NPI:1326445750
Name:HWANG, GENWARD (DPT)
Entity Type:Individual
Prefix:DR
First Name:GENWARD
Middle Name:
Last Name:HWANG
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:GEORGE
Other - Middle Name:
Other - Last Name:HWANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:9955 FAIR HAVEN DR
Mailing Address - Street 2:APT. H
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46280-2777
Mailing Address - Country:US
Mailing Address - Phone:317-450-1750
Mailing Address - Fax:
Practice Address - Street 1:2014 E MADISON ST
Practice Address - Street 2:#100
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-2965
Practice Address - Country:US
Practice Address - Phone:206-726-9595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-01
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT605169362251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic