Provider Demographics
NPI:1801214879
Name:SHIEH, CINDY YEN (DO)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:YEN
Last Name:SHIEH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 LIND AVS SW
Mailing Address - Street 2:SUITE 100 ATTN CREDENTIALING
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-4970
Mailing Address - Country:US
Mailing Address - Phone:425-690-2715
Mailing Address - Fax:
Practice Address - Street 1:1205 N 10TH ST STE 301-C
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-5577
Practice Address - Country:US
Practice Address - Phone:425-690-3540
Practice Address - Fax:425-690-9540
Is Sole Proprietor?:No
Enumeration Date:2014-04-07
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR3958207Q00000X
0390200000X
WAOP61031956207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2158287Medicaid
TX374172001Medicaid
TX374172002OtherCSHCN