Provider Demographics
NPI:1174891550
Name:TANG, SOPHIE HAIMING (FNP-C)
Entity type:Individual
Prefix:
First Name:SOPHIE
Middle Name:HAIMING
Last Name:TANG
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 SW 39TH ST STE 150
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-4912
Mailing Address - Country:US
Mailing Address - Phone:425-690-3485
Mailing Address - Fax:256-909-0854
Practice Address - Street 1:660 SW 39TH ST STE 150
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-4912
Practice Address - Country:US
Practice Address - Phone:425-690-3485
Practice Address - Fax:256-909-0854
Is Sole Proprietor?:No
Enumeration Date:2011-12-13
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95012320363LF0000X
WAAP61562596363L00000X
WARN61541019363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily