1649372756 NPI number — DANIEL T YANG MD

Table of content: DANIEL T YANG MD (NPI 1649372756)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649372756 NPI number — DANIEL T YANG MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YANG
Provider First Name:
DANIEL
Provider Middle Name:
T
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1649372756
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9631 N. NEVADA STREET
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
SPOKANE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
99218-1134
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-489-4040
Provider Business Mailing Address Fax Number:
509-489-9190

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9631 N NEVADA ST STE 300
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99218-1193
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-489-4040
Provider Business Practice Location Address Fax Number:
509-489-9190
Provider Enumeration Date:
09/01/2006

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:  MD00042479 , 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: 1118959 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1649372756 . This is a "NPI" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: DH1103 . This is a "RAILROAD MEDICARE GROUP NUMBER" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 178539 . This is a "L&I" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1134301989 . This is a "NPI CORP" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: P00472574 . This is a "RAILROAD MEDICARE PTAN" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 8853289 . This is a "MEDICARE GROUP PIN" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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