Provider Demographics
NPI:1013957661
Name:HUANG, YA-LAN (MD)
Entity type:Individual
Prefix:
First Name:YA-LAN
Middle Name:
Last Name:HUANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:YA-LAN
Other - Last Name:HUANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:12728 19TH AVE SE STE 300
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-6676
Mailing Address - Country:US
Mailing Address - Phone:425-252-1116
Mailing Address - Fax:425-252-1118
Practice Address - Street 1:12728 19TH AVE SE STE 300
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-6676
Practice Address - Country:US
Practice Address - Phone:425-252-6801
Practice Address - Fax:425-258-1944
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00039587207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0146965OtherLABOR AND INDUSTRY
WAMD00039587OtherSTATE LICENSE NUMBER
WA110236902OtherRAILROAD MEDICARE
WA8275539Medicaid
WAAB20213Medicare PIN
WA110236902OtherRAILROAD MEDICARE