| Jkw Medical Group | |
|
11504 Ne 21st St Bellevue WA 98004-3025 | |
| (425) 698-3033 | |
| (425) 968-6357 |
| Full Name | Jkw Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 11504 Ne 21st St, Bellevue, Washington |
| Authorized Official Name and Position | Jiakun Wang (OWNER) |
| Authorized Official Contact | 6154239545 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jkw Medical Group 11504 Ne 21st St Bellevue WA 98004-3025 Ph: (425) 698-3033 | Jkw Medical Group 11504 Ne 21st St Bellevue WA 98004-3025 Ph: (425) 698-3033 |
| NPI Number | 1023348497 |
|---|---|
| Provider Enumeration Date | 01/07/2010 |
| Last Update Date | 10/04/2022 |
| Medicare PECOS PAC ID | 9638205420 |
|---|---|
| Medicare Enrollment ID | O20100331000681 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023348497 | NPI | - | NPPES |
| 2005338 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD60003277 (Washington) | Primary |
| Provider Name | Jiakun Wang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912177627 PECOS PAC ID: 3476611245 Enrollment ID: I20081022000687 |
| Provider Name | Lili Yao |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407017510 PECOS PAC ID: 0244401511 Enrollment ID: I20110916000108 |
| Provider Name | Olga G Abramova |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285036228 PECOS PAC ID: 4688996002 Enrollment ID: I20141212002205 |
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