Provider Demographics
NPI:1376697433
Name:LIN, DZUKA (PT)
Entity Type:Individual
Prefix:MR
First Name:DZUKA
Middle Name:
Last Name:LIN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 9TH AVE NE
Mailing Address - Street 2:SUITE 360
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-8515
Mailing Address - Country:US
Mailing Address - Phone:206-523-5826
Mailing Address - Fax:206-428-2087
Practice Address - Street 1:6300 9TH AVE NE
Practice Address - Street 2:SUITE 360
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-8515
Practice Address - Country:US
Practice Address - Phone:206-523-5826
Practice Address - Fax:206-428-2087
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00008805225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8857265Medicare ID - Type UnspecifiedGROUP NUMBER
WA8857117Medicare ID - Type UnspecifiedPROVIDER NUMBER