Provider Demographics
NPI:1518984343
Name:HE, YAJUAN (MD,PHD)
Entity Type:Individual
Prefix:DR
First Name:YAJUAN
Middle Name:
Last Name:HE
Suffix:
Gender:F
Credentials:MD,PHD
Other - Prefix:
Other - First Name:JUNE
Other - Middle Name:
Other - Last Name:HE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1901 S UNION AVE
Mailing Address - Street 2:SUITE B7011
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1702
Mailing Address - Country:US
Mailing Address - Phone:253-627-5755
Mailing Address - Fax:253-627-7385
Practice Address - Street 1:1901 S UNION AVE
Practice Address - Street 2:SUITE B7011
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1702
Practice Address - Country:US
Practice Address - Phone:253-627-5755
Practice Address - Fax:253-627-7385
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-16
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00040949174400000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8299273Medicaid
WA91-1500604OtherREGENCE B.C.B.S
WA91-1500604OtherPREMERA BLUE CROSS
WA91-1500604OtherUNITED HEALTHCARE
WA91-1500604OtherAETNA
WA91-1500604OtherPACIFICARE
WA91-1500604OtherUNITED HEALTHCARE
WA91-1500604OtherPREMERA BLUE CROSS
WAGAB28154Medicare PIN