Provider Demographics
NPI:1760460240
Name:WANG, YING M (MD)
Entity Type:Individual
Prefix:DR
First Name:YING
Middle Name:M
Last Name:WANG
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 1:19020 33RD AVE W
Mailing Address - Street 2:STE 210
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-4746
Mailing Address - Country:US
Mailing Address - Phone:425-563-1500
Mailing Address - Fax:425-563-1374
Practice Address - Street 1:19020 33RD AVE W
Practice Address - Street 2:STE 210
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-4746
Practice Address - Country:US
Practice Address - Phone:425-563-1500
Practice Address - Fax:425-563-1374
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000441702085B0100X, 2085R0202X, 2085R0204X
IDM-123742085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA192389OtherL&I PROVIDER
WA204126OtherL&I PROVIDER ID
WA192387OtherL&I PROVIDER
WA8413841Medicaid
ID1760460240Medicaid
WA192388OtherL&I PROVIDER
WA204126OtherL&I PROVIDER ID
WA192388OtherL&I PROVIDER
WA192387OtherL&I PROVIDER
WAH33004Medicare UPIN
WAG8857901Medicare PIN
ID20005752Medicare PIN
WAG8808837Medicare PIN
WAG8808841Medicare PIN
WA8862888Medicare PIN
WA192389OtherL&I PROVIDER
WA8413841Medicaid