Convoy Union Medical Clinic

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

MD00047633 Issued in WA

Legal business name

CONVOY UNION MEDICAL CLINIC

Practice address

1414 116TH Ave NE Ste F
Bellevue, WA 98004-3801

Phone

(425) 765-3999

NPI assigned

Feb 19, 2012

Reactivated

Nov 14, 2013

Organization subpart

No

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

Authorized official

Name

Zhiqian Wang

Title

MD

Phone

(425) 765-3999

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1329609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384387200000",
    "number": "1760755995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 116TH AVE NE STE F",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 116TH AVE NE STE F",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043801",
            "telephone_number": "425-765-3999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONVOY UNION MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-19",
        "last_updated": "2013-11-14",
        "deactivation_date": "2012-08-14",
        "reactivation_date": "2013-11-14",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "ZHIQIAN",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "425-765-3999"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WA",
            "license": "MD00047633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Contact Lens Consultants Northwest
• Carla Maria Conte, OT
• Lang Conteh, CRNA
• Maria Hereri Contreras, MAFT, RC
• Maya Ynez Contreras
• Molly Ann Cook, LICSW
• Sarah Kasiah Cook
• Tessa Nicole Cooke, CN, LMHCA
• Julianne Cool, RD
• Aaron C Cooley

• Clinic/Center in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.