1528183092 NPI number — ZHONGJIAN QIAN O.D.

Table of content: DEREK SUNIL NOWRANGI (NPI 1063156297)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528183092 NPI number — ZHONGJIAN QIAN O.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
QIAN
Provider First Name:
ZHONGJIAN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
O.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHIEN
Provider Other First Name:
OLIVER
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
O.D.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1528183092
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
900 S JACKSON ST
Provider Second Line Business Mailing Address:
SUITE 216
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98104-3058
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-838-1096
Provider Business Mailing Address Fax Number:
206-838-1093

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
900 S JACKSON ST
Provider Second Line Business Practice Location Address:
SUITE 216
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98104-3058
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-838-1096
Provider Business Practice Location Address Fax Number:
206-838-1093
Provider Enumeration Date:
03/21/2007

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: 152W00000X , with the licence number:  OD00003076 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2027340 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




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