Provider Demographics
NPI:1871547927
Name:FUNG, FRANK P S (MD)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:P S
Last Name:FUNG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3600 LIND AVE SW
Mailing Address - Street 2:SUITE 100 ATTN CREDENTIALING
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-4970
Mailing Address - Country:US
Mailing Address - Phone:425-690-2715
Mailing Address - Fax:
Practice Address - Street 1:24920 104TH AVE SE
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-6443
Practice Address - Country:US
Practice Address - Phone:425-690-3544
Practice Address - Fax:425-690-9444
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2020-03-05
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Provider Licenses
StateLicense IDTaxonomies
WAMD00035164207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2109149Medicaid
WA8239311Medicaid
WA0173100OtherLABOR & IND
WAG8896016OtherMEDICARE - VALLEY MEDICAL GROUP