Provider Demographics
NPI:1578893475
Name:DOROTHY N YANG MD INC PS
Entity Type:Organization
Organization Name:DOROTHY N YANG MD INC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:N
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-292-7500
Mailing Address - Street 1:1221 MADISON ST STE 1018
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1380
Mailing Address - Country:US
Mailing Address - Phone:206-292-7500
Mailing Address - Fax:206-292-6408
Practice Address - Street 1:1221 MADISON ST STE 1018
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-1380
Practice Address - Country:US
Practice Address - Phone:206-292-7500
Practice Address - Fax:206-292-6408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-28
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207N00000X
WA18580261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG000105954Medicare PIN