Provider Demographics
NPI:1558316372
Name:AYEE, KYAWT KYAWT (MD)
Entity Type:Individual
Prefix:
First Name:KYAWT
Middle Name:KYAWT
Last Name:AYEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JOJO
Other - Middle Name:
Other - Last Name:AYEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3900 S ZINTEL WAY
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99338
Mailing Address - Country:US
Mailing Address - Phone:509-942-3627
Mailing Address - Fax:509-942-2268
Practice Address - Street 1:560 GAGE BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352
Practice Address - Country:US
Practice Address - Phone:509-942-3135
Practice Address - Fax:509-627-1188
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK24921207R00000X, 207RG0300X
WA00049016207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0242833OtherLABOR & INDUSTRIES
WA8522195Medicaid
WA0242833OtherLABOR & INDUSTRIES
WA8522195Medicaid