Provider Demographics
NPI:1215959283
Name:FEDERAL WAY WOMENS HEALTH CARE
Entity type:Organization
Organization Name:FEDERAL WAY WOMENS HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SUYANG
Authorized Official - Middle Name:
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:253-838-0219
Mailing Address - Street 1:PO BOX 3497
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98063-3497
Mailing Address - Country:US
Mailing Address - Phone:253-838-0219
Mailing Address - Fax:253-838-3449
Practice Address - Street 1:32114 1ST AVE S
Practice Address - Street 2:STE 203
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-5760
Practice Address - Country:US
Practice Address - Phone:253-838-0219
Practice Address - Fax:253-838-3449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00046108174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty