Provider Demographics
NPI:1174199459
Name:WANG, SHIYUE
Entity type:Individual
Prefix:
First Name:SHIYUE
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12295 138TH PL NE UNIT 105
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-1422
Mailing Address - Country:US
Mailing Address - Phone:402-609-9372
Mailing Address - Fax:
Practice Address - Street 1:12295 138TH PL NE UNIT 105
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-1422
Practice Address - Country:US
Practice Address - Phone:402-609-9372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-27
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171R00000X
WARN61349976163W00000X
WAAP70026402363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No171R00000XOther Service ProvidersInterpreter
No163W00000XNursing Service ProvidersRegistered Nurse