Basic Information
| Provider Information | |||||||||
| NPI: | 1598930471 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ZHAO | ||||||||
| FirstName: | YONGDONG | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | |||||||||
| OtherFirstName: | |||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | |||||||||
| Mailing Information | |||||||||
| Address1: | 4800 SAND POINT WAY NE | ||||||||
| Address2: | M.A. 7.110 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981052601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2069872057 | ||||||||
| FaxNumber: | 2069875060 | ||||||||
| Practice Location | |||||||||
| Address1: | 4800 SAND POINT WAY NE, | ||||||||
| Address2: | M/S MA7.110 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2069872057 | ||||||||
| FaxNumber: | 2069875060 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2008 | ||||||||
| LastUpdateDate: | 06/12/2019 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | M | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | MD60329823 | WA | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | MD443409 | PA | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 26318 | MT | N | Allopathic & Osteopathic Physicians | Pediatrics | 2080P0216X | MD60329823 | WA | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Rheumatology |
No ID Information.