Provider Demographics
NPI:1619395738
Name:LUO, JING (MD)
Entity Type:Individual
Prefix:DR
First Name:JING
Middle Name:
Last Name:LUO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19020 33RD AVE W STE 210
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-4748
Mailing Address - Country:US
Mailing Address - Phone:425-563-1500
Mailing Address - Fax:425-563-1374
Practice Address - Street 1:201 16TH AVE E
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-5226
Practice Address - Country:US
Practice Address - Phone:206-326-3000
Practice Address - Fax:206-326-2785
Is Sole Proprietor?:No
Enumeration Date:2014-04-04
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD606758822085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0425499OtherL&I-VANCOUVER RADIOLOGY
WA0425490OtherL&I-RADIA REST OF WA
WA0425491OtherL&I-RADIA KING CTY
WA0425496OtherL&I-SOUTH SOUND RADIOLOGY
WA0425498OtherL&I-SEATTLE RADIOLOGY
WA2045547Medicaid
WA0425492OtherL&I-SWEDISH RADIA EDMONDS
WA0425494OtherL&I-EVERGREEN RADIA