1104854975 NPI number — DR. XIAYING SHERRI ZHU M.D.

Table of content: DR. XIAYING SHERRI ZHU M.D. (NPI 1104854975)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104854975 NPI number — DR. XIAYING SHERRI ZHU M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZHU
Provider First Name:
XIAYING
Provider Middle Name:
SHERRI
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1104854975
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/21/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1041 116TH AVE NE
Provider Second Line Business Mailing Address:
STE 117
Provider Business Mailing Address City Name:
BELLEVUE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98004-4604
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-467-3842
Provider Business Mailing Address Fax Number:
425-467-3849

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1041 116TH AVE NE
Provider Second Line Business Practice Location Address:
STE 117
Provider Business Practice Location Address City Name:
BELLEVUE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98004-4604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-467-3842
Provider Business Practice Location Address Fax Number:
425-467-3849
Provider Enumeration Date:
06/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  MD60268787 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208M00000X , with the licence number: MD 60268787 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RR0500X , with the licence number: MD 60268787 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 042081202 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 042081205 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8P9614 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 042081203 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 042081204 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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