1841266962 NPI number — VERA H CHENG M.D.

Table of content: VERA H CHENG M.D. (NPI 1841266962)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841266962 NPI number — VERA H CHENG M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHENG
Provider First Name:
VERA
Provider Middle Name:
H
Provider Name Prefix Text:
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:
1841266962
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/16/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
601 W 5TH AVE
Provider Second Line Business Mailing Address:
SUITE 400
Provider Business Mailing Address City Name:
SPOKANE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
99204-2715
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-344-2663
Provider Business Mailing Address Fax Number:
509-624-9179

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
601 W 5TH AVE
Provider Second Line Business Practice Location Address:
SUITE 500
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99204-2756
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-344-2663
Provider Business Practice Location Address Fax Number:
509-624-9179
Provider Enumeration Date:
02/28/2006

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: 174400000X , with the licence number:  MD00030077 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207L00000X , with the licence number: MD00030077 , 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: E12652 . This is a "ASURIS NW HEALTH" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 8156598 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 192265 . This is a "DEPT OF LABOR & INDUSTRIE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: P00213217 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 379109600 . This is a "OWCP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0092973 . This is a "MONTANA MEDICAID" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: KY456 . This is a "HMO BLUE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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