Provider Demographics
NPI:1659395705
Name:WU, GRACE WENCHEN HSIAO (DMD)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:WENCHEN HSIAO
Last Name:WU
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:WENCHEN
Other - Last Name:HSIAO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:19020 33RD AVE W STE 320
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:425-771-4427
Mailing Address - Fax:425-771-0086
Practice Address - Street 1:19020 33RD AVE W STE 320
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-4748
Practice Address - Country:US
Practice Address - Phone:425-771-4427
Practice Address - Fax:425-771-0086
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA600170721223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics