Provider Demographics
NPI:1770648198
Name:LU, HENRY LI-HEN (PT)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:LI-HEN
Last Name:LU
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1037 NE 65TH ST
Mailing Address - Street 2:#115
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-6655
Mailing Address - Country:US
Mailing Address - Phone:206-905-8575
Mailing Address - Fax:206-905-8554
Practice Address - Street 1:4501 INTERLAKE AVE N STE 8
Practice Address - Street 2:#115
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-6700
Practice Address - Country:US
Practice Address - Phone:206-905-8575
Practice Address - Fax:206-905-8554
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAPT000094662251X0800X
0204021412255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
8863778Medicare PIN