Individual
DR. WAYNE SY FANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19020 33RD AVE W, SUITE 210, LYNNWOOD, WA 98036-4748
(425) 563-1500
(425) 563-1501
Mailing address
19020 33RD AVE W STE 210, LYNNWOOD, WA 98036-4748
(425) 563-1500
(425) 563-1374
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
MD60082880
WA
2085R0202X
Diagnostic Radiology Physician
46465 - 020
WI
2085R0202X
Diagnostic Radiology Physician
MD60082880
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0367297
L&I-RADIA REST OF WA
WA
01
—
0367298
L&I-RADIA KING COUNTY
WA
01
—
0367299
L&I-SWEDISH RADIA EDMONDS
WA
01
—
0367300
L&I-EVERGREEN RADIA
WA
01
—
0385162
L&I-SOUTH SOUND RADIOLOGY
WA
05
—
2000900
—
WA
Enumeration date
10/26/2006
Last updated
03/29/2019
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