Provider Demographics
NPI:1609114172
Name:WANG, IWEI (PSYCHOLOGIST)
Entity Type:Individual
Prefix:DR
First Name:IWEI
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 112TH AVE NE STE B100
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3751
Mailing Address - Country:US
Mailing Address - Phone:425-462-1132
Mailing Address - Fax:303-436-5157
Practice Address - Street 1:1200 112TH AVE NE STE B100
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3751
Practice Address - Country:US
Practice Address - Phone:425-462-1132
Practice Address - Fax:303-436-5157
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-17
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY0005816103TC0700X
COLPC30012442101YP2500X
WAPY61356985103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional