Provider Demographics
NPI:1396556254
Name:WHANG, TIMOTHY Y
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:Y
Last Name:WHANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19310 76TH PL NE
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:WA
Mailing Address - Zip Code:98028-2697
Mailing Address - Country:US
Mailing Address - Phone:317-427-8593
Mailing Address - Fax:
Practice Address - Street 1:19310 76TH PL NE
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:WA
Practice Address - Zip Code:98028-2697
Practice Address - Country:US
Practice Address - Phone:317-427-8593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-18
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter