Active NPI
Charles R Wang, MD
- Psychiatry Physician
- Bellevue, WA
National Provider Identifier
1750351532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 025209 MD00029068
- Practice address
- 1300 114TH Ave SE
Suite 115
Bellevue, WA 98004-6942 - Phone
- (425) 462-9511
- Fax
- (425) 462-8894
- NPI assigned
- Jan 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 025209 MD00029068 | WA | Primary |
Addresses
Primary practice location
1300 114TH Ave SE
Suite 115
Bellevue, WA 98004-6942
Mailing address
1300 114TH Ave SE
Suite 115
Bellevue, WA 98004-6942
Phone (425) 462-9511
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 025209 MD00029068 | WA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425859200000",
"number": "1750351532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 114TH AVE SE",
"address_2": "SUITE 115",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980046942",
"telephone_number": "425-462-9511",
"fax_number": "425-462-8894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 114TH AVE SE",
"address_2": "SUITE 115",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980046942",
"telephone_number": "425-462-9511",
"fax_number": "425-462-8894"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANG",
"first_name": "CHARLES",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-25",
"last_updated": "2015-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "WA",
"license": "025209 MD00029068",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.