Individual
DR. DARRYL DEAN TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7424 BRIDGEPORT WAY W, SUITE 203, LAKEWOOD, WA 98499-8120
(253) 581-2523
(253) 581-2712
Mailing address
7424 BRIDGEPORT WAY W, SUITE 203, LAKEWOOD, WA 98499-8120
(253) 581-2523
(253) 581-2712
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD00027208
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
186557
L&I
WA
05
—
8309668
—
WA
01
—
8925991
CRIME VICTIMS
WA
01
—
TA2603
BLUE CROSS/BLUE SHIELD
WA
Enumeration date
08/01/2006
Last updated
07/08/2007
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