Individual
LAWRENCE PEI-WEN WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
16735 SE 272ND ST, SUITE C, COVINGTON, WA 98042-4942
(253) 639-4077
Mailing address
PO BOX 1834, ISSAQUAH, WA 98027-0075
(425) 687-7981
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3495
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2030690
—
WA
01
—
WA1418
REGENCE BLUE SHIELD
WA
Enumeration date
02/18/2007
Last updated
07/09/2007
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