Provider Demographics
NPI:1760415251
Name:HSUE, MINDY L (MD)
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:L
Last Name:HSUE
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 1:18100 NE UNION HILL RD
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3330
Mailing Address - Country:US
Mailing Address - Phone:425-702-8689
Mailing Address - Fax:206-320-5191
Practice Address - Street 1:18100 NE UNION HILL RD
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3330
Practice Address - Country:US
Practice Address - Phone:425-702-8689
Practice Address - Fax:206-320-5191
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD39837207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8281883Medicaid
H42584Medicare UPIN
WA8281883Medicaid
WAAB37815Medicare ID - Type Unspecified