Provider Demographics
NPI:1134347040
Name:WANG, YUN GUO (LAC)
Entity type:Individual
Prefix:
First Name:YUN
Middle Name:GUO
Last Name:WANG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11046 LAKE CITY WAY NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-6717
Mailing Address - Country:US
Mailing Address - Phone:206-367-9180
Mailing Address - Fax:206-367-9180
Practice Address - Street 1:11046 LAKE CITY WAY NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-6717
Practice Address - Country:US
Practice Address - Phone:206-367-9180
Practice Address - Fax:206-367-9180
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACA0000188171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist