Provider Demographics
NPI:1720070162
Name:YANG, DOROTHY N (MD)
Entity type:Individual
Prefix:
First Name:DOROTHY
Middle Name:N
Last Name:YANG
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 1:1221 MADISON ST STE 1018
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1380
Mailing Address - Country:US
Mailing Address - Phone:206-292-7500
Mailing Address - Fax:206-292-6408
Practice Address - Street 1:1221 MADISON ST STE 1018
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-1380
Practice Address - Country:US
Practice Address - Phone:206-292-7500
Practice Address - Fax:206-292-6408
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-22
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA18580207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1895101Medicaid
WAG8888965Medicare PIN
WA1895101Medicaid