Provider Demographics
NPI:1881012615
Name:JIN, WENDY (MD)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:
Last Name:JIN
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 1:316 MARTIN LUTHER KING JR WAY STE 212
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4254
Mailing Address - Country:US
Mailing Address - Phone:253-383-5777
Mailing Address - Fax:
Practice Address - Street 1:316 MARTIN LUTHER KING JR WAY STE 212
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4254
Practice Address - Country:US
Practice Address - Phone:253-383-5777
Practice Address - Fax:608-417-8801
Is Sole Proprietor?:No
Enumeration Date:2014-03-29
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD187563208000000X
OH35129256208000000X
WI73355208000000X
WAMD61364163208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics