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Individual

HAO Q TO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1959 NE PACIFIC ST, SEATTLE, WA 98195-4725
(206) 543-3605
Mailing address
1959 NE PACIFIC ST, SEATTLE, WA 98195-6421

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
61426281
WA

Other

Enumeration date
03/24/2023
Last updated
05/24/2023
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