1689625014 NPI number — HUI-JUAN ZHANG MD, PHD

Table of content: HUI-JUAN ZHANG MD, PHD (NPI 1689625014)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689625014 NPI number — HUI-JUAN ZHANG MD, PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZHANG
Provider First Name:
HUI-JUAN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD, PHD
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:
1689625014
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:
3900 S ZINTEL WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KENNEWICK
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
99337-5092
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-942-3627
Provider Business Mailing Address Fax Number:
509-942-2268

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1100 GOETHALS DRIVE
Provider Second Line Business Practice Location Address:
1ST FLOOR
Provider Business Practice Location Address City Name:
RICHLAND
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99352-3304
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-946-7931
Provider Business Practice Location Address Fax Number:
509-946-7223
Provider Enumeration Date:
05/12/2006

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: 2084N0400X , with the licence number:  MD00040298 , 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: 1114537 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 155649 . This is a "DEPT. OF L&I" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: P00066718 . This is a "RAILROAD MEDICARE PIN" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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