Provider Demographics
NPI:1518490689
Name:WANG, JUNE (MD)
Entity Type:Individual
Prefix:
First Name:JUNE
Middle Name:
Last Name:WANG
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 1:34709 9TH AVE S STE B500
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6789
Mailing Address - Country:US
Mailing Address - Phone:253-944-6950
Mailing Address - Fax:253-944-6986
Practice Address - Street 1:34709 9TH AVE S STE B500
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6789
Practice Address - Country:US
Practice Address - Phone:253-944-6950
Practice Address - Fax:253-944-6986
Is Sole Proprietor?:No
Enumeration Date:2017-04-06
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD61140975207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2180662Medicaid