Provider Demographics
NPI:1174323190
Name:XU, XUEYING (PAC)
Entity type:Individual
Prefix:
First Name:XUEYING
Middle Name:
Last Name:XU
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4205 KITSAP WAY
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98312-2447
Mailing Address - Country:US
Mailing Address - Phone:360-782-7780
Mailing Address - Fax:360-782-7789
Practice Address - Street 1:4205 KITSAP WAY
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98312-2447
Practice Address - Country:US
Practice Address - Phone:360-782-7780
Practice Address - Fax:360-782-7789
Is Sole Proprietor?:No
Enumeration Date:2025-03-18
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA70044782363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical