Provider Demographics
NPI:1104144021
Name:MA, ZHENDONG JEFF (MD, PHD)
Entity type:Individual
Prefix:
First Name:ZHENDONG
Middle Name:JEFF
Last Name:MA
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1808 RICHARDS RD STE 120
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-3982
Mailing Address - Country:US
Mailing Address - Phone:425-679-6417
Mailing Address - Fax:
Practice Address - Street 1:1808 RICHARDS RD STE 120
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-3982
Practice Address - Country:US
Practice Address - Phone:425-679-6417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-17
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD 604588632084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry