Provider Demographics
NPI:1043223498
Name:WU, CATHERINE C (DMD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:C
Last Name:WU
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9243 NE GLISAN
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97220-4533
Mailing Address - Country:US
Mailing Address - Phone:503-255-1650
Mailing Address - Fax:
Practice Address - Street 1:9243 NE GLISAN
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220-4533
Practice Address - Country:US
Practice Address - Phone:503-255-1650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD4907122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist