Provider Demographics
NPI:1578525689
Name:ZHOU, KEVIN YAN-TING (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:YAN-TING
Last Name:ZHOU
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 1:202 N DIVISION ST
Mailing Address - Street 2:STE 201
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98001-4939
Mailing Address - Country:US
Mailing Address - Phone:253-939-1230
Mailing Address - Fax:253-735-1211
Practice Address - Street 1:202 N DIVISION ST
Practice Address - Street 2:STE 201
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98001-4939
Practice Address - Country:US
Practice Address - Phone:253-939-1230
Practice Address - Fax:253-735-1211
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00042978207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0280781OtherSTATE L&I
WA0280794OtherSTATE L&I
WA8385320Medicaid
WA0280790OtherSTATE L&I
WA8802794Medicare ID - Type Unspecified
WA8385320Medicaid
WAI03657Medicare UPIN