Provider Demographics
NPI:1124295423
Name:YOUNG, WILLIAM GREGORY JR (MD)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:GREGORY
Last Name:YOUNG
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:12333 NE 130TH LN STE 440
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-7467
Mailing Address - Country:US
Mailing Address - Phone:425-899-3838
Mailing Address - Fax:425-899-3844
Practice Address - Street 1:12333 NE 130TH LN STE 440
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-7467
Practice Address - Country:US
Practice Address - Phone:425-899-3838
Practice Address - Fax:425-899-3844
Is Sole Proprietor?:No
Enumeration Date:2008-05-15
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI60380207Y00000X
WAMD60454300207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA329560OtherWA LABOR & INDUSTRIES
WA2037547Medicaid