Provider Demographics
NPI:1124280797
Name:WU, JIANG (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:JIANG
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 116TH AVE NE
Mailing Address - Street 2:LL140
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004
Mailing Address - Country:US
Mailing Address - Phone:425-467-3842
Mailing Address - Fax:425-688-5009
Practice Address - Street 1:1035 116TH AVE NE
Practice Address - Street 2:LL140
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004
Practice Address - Country:US
Practice Address - Phone:425-467-3842
Practice Address - Fax:425-688-5009
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-25
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-099829207R00000X
OH35.099829208M00000X
WAMD60707274208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine