Provider Demographics
NPI:1205135092
Name:ZHAO, GE (MD,PHD)
Entity type:Individual
Prefix:
First Name:GE
Middle Name:
Last Name:ZHAO
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:PO BOX 3348
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98009-3348
Mailing Address - Country:US
Mailing Address - Phone:425-400-8008
Mailing Address - Fax:877-880-6829
Practice Address - Street 1:11711 NE 12TH ST STE 2C
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2461
Practice Address - Country:US
Practice Address - Phone:425-400-8008
Practice Address - Fax:877-880-6829
Is Sole Proprietor?:No
Enumeration Date:2011-03-21
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60537019207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2019152Medicaid
WAG8952203Medicare PIN