Provider Demographics
NPI:1588847271
Name:LEUNG, KEVIN K (MD)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:K
Last Name:LEUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33915 1ST WAY S STE 200
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6396
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:33915 1ST WAY S STE 200
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6396
Practice Address - Country:US
Practice Address - Phone:253-272-5127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-17
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00049118207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAP00714041OtherRR MEDICARE #
WA8507550Medicaid
WAMD00049118OtherWA LICENSE
WAMD00049118OtherWA LICENSE
WAP00714041OtherRR MEDICARE #
WAG8880511Medicare PIN
WA001045700Medicare PIN
WAG8851596Medicare PIN
WA8851594Medicare PIN
WA8507550Medicaid
WAG8851595Medicare PIN
WAG8874783Medicare PIN
WA000188100Medicare PIN