Individual
LANCY MIMI TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
19930 BALLINGER WAY NE, SHORELINE, WA 98155-1223
(425) 778-2220
(425) 778-7701
Mailing address
19930 BALLINGER WAY NE, SHORELINE, WA 98155-1223
(425) 778-2220
(425) 778-7701
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD210187
OR
208600000X
Surgery Physician
Primary
MD61170965
WA
Other
Enumeration date
03/27/2017
Last updated
04/05/2024
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