Provider Demographics
NPI:1093381626
Name:LU, MENG (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MENG
Middle Name:
Last Name:LU
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:MANDY
Other - Middle Name:
Other - Last Name:LU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:12345 LAKE CITY WAY NE # 2022
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-5401
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1410 NE CAMPUS PKWY
Practice Address - Street 2:401 SCHMITZ HALL
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-0003
Practice Address - Country:US
Practice Address - Phone:425-405-0648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-03
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61016305103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical