Provider Demographics
NPI:1568430908
Name:TAN, SWEE LIAN (MD)
Entity Type:Individual
Prefix:
First Name:SWEE LIAN
Middle Name:
Last Name:TAN
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:PO BOX 22152
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-0152
Mailing Address - Country:US
Mailing Address - Phone:206-420-3119
Mailing Address - Fax:206-453-5912
Practice Address - Street 1:515 MINOR AVE STE 240
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2133
Practice Address - Country:US
Practice Address - Phone:206-420-3119
Practice Address - Fax:206-453-5912
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000432542086S0129X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1568430908Medicaid
WA262683OtherLABOR & INDUSTRY
WA0096TAOtherREGENCE
WA8383390Medicaid
WA8383390Medicaid
WA0096TAOtherREGENCE
WA8802015Medicare ID - Type Unspecified
WA1568430908Medicaid
WA8891132Medicare PIN
AKFT2849137OtherDEA
AK0361450001Medicare NSC