Provider Demographics
NPI:1639179401
Name:BINGCANG, PETER P (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:P
Last Name:BINGCANG
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 1:7501 92ND AVENUE CT SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98498-3973
Mailing Address - Country:US
Mailing Address - Phone:253-588-0058
Mailing Address - Fax:253-589-4862
Practice Address - Street 1:202 N DIVISION ST
Practice Address - Street 2:PLZA 1
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98001-4939
Practice Address - Country:US
Practice Address - Phone:253-804-2813
Practice Address - Fax:253-804-2886
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000219412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAB17150OtherREGENCE BLUE SHIELD
P00001918OtherRAILROAD MEDICARE
WA1101310Medicaid
WAB17150OtherREGENCE BLUE SHIELD
WA1101310Medicaid