Provider Demographics
NPI:1184203325
Name:WU, JUN (L AC)
Entity Type:Individual
Prefix:
First Name:JUN
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12522 8TH AVE W APT F102
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-1860
Mailing Address - Country:US
Mailing Address - Phone:872-888-3833
Mailing Address - Fax:
Practice Address - Street 1:15230 NE 24TH ST # 1
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-5540
Practice Address - Country:US
Practice Address - Phone:872-888-3833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-05
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC61132525171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist