Provider Demographics
NPI:1306955166
Name:WANG, CHIA C (MD)
Entity type:Individual
Prefix:DR
First Name:CHIA
Middle Name:C
Last Name:WANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 9TH AVE
Mailing Address - Street 2:MS: M4-PFS
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2756
Mailing Address - Country:US
Mailing Address - Phone:206-515-5811
Mailing Address - Fax:206-515-5886
Practice Address - Street 1:1100 9TH AVE
Practice Address - Street 2:G2-ID
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2756
Practice Address - Country:US
Practice Address - Phone:206-341-0846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00032128207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8249013Medicaid
WAP00444053OtherRAILROAD MC VM
WA223017OtherL & I
WA8882647OtherMEDICARE
WA5887WAOtherBLUE SHIELD VM
WA1306955166OtherMONTANA MEDICAID
WA7897WAOtherREGENCE BLUESHIELD
WAUS7577053OtherATENA PCP PIN VM
WAG8884739Medicare PIN
WAUS7577053OtherATENA PCP PIN VM
WA8249013Medicaid