Basic Information
| Provider Information | |||||||||
| NPI: | 1982917720 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHEUNG | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | KING HEI | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 50095 | ||||||||
| Address2: | UNIVERSITY OF WASHINGTON, DEPT. OF RADIATION ONCOLOGY | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981455095 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2065205700 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1959 NE PACIFIC ST | ||||||||
| Address2: | UNIVERSITY OF WASHINGTON, DEPT. OF RADIATION ONCOLOGY | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981950001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2065984100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2010 | ||||||||
| LastUpdateDate: | 09/08/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0001X | MD60542197 | WA | Y | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
ID Information
| ID | Type | State | Issuer | Description | 1982917720 | 05 | WA | MEDICAID |