Alice Hyun-Kyung Tan, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

61094526 Issued in WA

Practice address

18700 SE 65TH PL
Issaquah, WA 98027-8668

Phone

(425) 270-0648

NPI assigned

Sep 13, 2022

Last updated

Sep 13, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1663027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1164144549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18700 SE 65TH PL",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980278668",
            "telephone_number": "425-270-0648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18700 SE 65TH PL",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980278668",
            "telephone_number": "425-270-0648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "ALICE",
        "middle_name": "HYUN-KYUNG",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-13",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "61094526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE CREDENTIAL",
            "identifier": "61094526",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mhtan@sam2tech.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "18700 SE 65th Pl",
            "city": "Issaquah",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980278668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Terri Lynn Talich, RN, CMSRN
• Dayna J Talley
• Michael H Tam, O.D.
• Vicky Wingkei Tam, LMT
• Tamura Arthun, a Professional Corporation (Grace Counseling Center)
• Krystal Tanis, MA60182498
• Tanner & Tanner, PLLC (Tanner Smiles)
• Helen Elise Tanner, RDH, BS
• Robert E Tanner, D.D.S.
• Nancy Tapia

• Internal Medicine Physician in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.