Basic Information
Provider Information
NPI: 1194014886
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LAM
FirstName: NY-YING
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 50095
Address2:  
City: SEATTLE
State: WA
PostalCode: 981455095
CountryCode: US
TelephoneNumber: 2065205700
FaxNumber:  
Practice Location
Address1: 1959 NE PACIFIC ST
Address2:  
City: SEATTLE
State: WA
PostalCode: 981950001
CountryCode: US
TelephoneNumber: 2065984295
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/01/2011
LastUpdateDate: 11/24/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208100000X60558823WAY Allopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation 

ID Information
IDTypeStateIssuerDescription
119401488605WA MEDICAID


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