Provider Demographics
NPI:1306517297
Name:JIE DENG, MD PLLC
Entity type:Organization
Organization Name:JIE DENG, MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DENG
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:425-454-5767
Mailing Address - Street 1:1600 116TH AVE NE STE 104
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3055
Mailing Address - Country:US
Mailing Address - Phone:425-454-5767
Mailing Address - Fax:833-559-1134
Practice Address - Street 1:1600 116TH AVE NE STE 104
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3055
Practice Address - Country:US
Practice Address - Phone:425-454-5767
Practice Address - Fax:833-559-1134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty