Provider Demographics
NPI:1669829289
Name:YEUNG, ROSANNA HOI LAM (MD)
Entity Type:Individual
Prefix:
First Name:ROSANNA
Middle Name:HOI LAM
Last Name:YEUNG
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 34738
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1738
Mailing Address - Country:US
Mailing Address - Phone:425-899-1600
Mailing Address - Fax:
Practice Address - Street 1:12040 NE 128TH ST # MS -63
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034
Practice Address - Country:US
Practice Address - Phone:425-899-1860
Practice Address - Fax:425-899-1859
Is Sole Proprietor?:No
Enumeration Date:2016-05-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA606478982085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1669829289Medicaid
WA1669829289OtherNPI
WA8954967Medicare PIN