Provider Demographics
NPI:1649403866
Name:SU, DENNIS LIEN-HSUN (MD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:LIEN-HSUN
Last Name:SU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 TALBOT RD S
Mailing Address - Street 2:SUITE 101
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-6238
Mailing Address - Country:US
Mailing Address - Phone:253-735-4341
Mailing Address - Fax:253-833-2071
Practice Address - Street 1:4300 TALBOT RD S
Practice Address - Street 2:SUITE 101
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-6238
Practice Address - Country:US
Practice Address - Phone:253-735-4341
Practice Address - Fax:253-833-2071
Is Sole Proprietor?:No
Enumeration Date:2009-09-03
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA601068702086S0129X
OH898702086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery