Provider Demographics
NPI:1558405043
Name:YAU, EDWIN JASON (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:JASON
Last Name:YAU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19020 33RD AVE W
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-4746
Mailing Address - Country:US
Mailing Address - Phone:425-563-1500
Mailing Address - Fax:425-563-1374
Practice Address - Street 1:19020 33RD AVE W
Practice Address - Street 2:SUITE 210
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-4746
Practice Address - Country:US
Practice Address - Phone:425-563-1500
Practice Address - Fax:425-563-1374
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000493372085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0237396OtherL&I
WA0248050OtherL&I EVERGREEN RADIA
WA8516569Medicaid
WA0248088OtherL&I RADIA-REST OF WA
WA0248109OtherL&I SWEDISH RADIA
WA0248109OtherL&I SWEDISH RADIA
WAG8881360Medicare PIN
WA0248088OtherL&I RADIA-REST OF WA
WAG8881358Medicare PIN
WAG8881357Medicare PIN