Provider Demographics
NPI:1407047558
Name:HWANG, DICK GUANG-IONG (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:DICK
Middle Name:GUANG-IONG
Last Name:HWANG
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 9TH AVE
Mailing Address - Street 2:MS:M4-PFS
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2756
Mailing Address - Country:US
Mailing Address - Phone:206-515-5811
Mailing Address - Fax:
Practice Address - Street 1:1100 9TH AVE
Practice Address - Street 2:MAILSTOP C6-PTH
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2756
Practice Address - Country:US
Practice Address - Phone:206-625-7373
Practice Address - Fax:206-341-0525
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA233077207ZP0102X
WAMD60288034207ZH0000X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1407047558OtherMONTANA DSHS
WA0297074OtherLABOR AND INDUSTRY
WAP01114180OtherRAILROAD MEDICARE
WA1407047558Medicaid
WA8911293Medicare PIN
WA1407047558OtherMONTANA DSHS
WA8917707Medicare PIN