Individual
KEN S WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1220 DIVISION AVE, TACOMA, WA 98403-1321
(253) 403-1685
Mailing address
1220 DIVISION AVE, TACOMA, WA 98403-1321
(253) 403-1685
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD60171772
WA
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
MD60171772
WA
Other
Enumeration date
10/20/2006
Last updated
04/10/2012
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