Provider Demographics
NPI:1790469450
Name:JADE WU BEHAVIORAL SLEEP MEDICINE PLLC
Entity Type:Organization
Organization Name:JADE WU BEHAVIORAL SLEEP MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JADE
Authorized Official - Middle Name:
Authorized Official - Last Name:WU
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:612-819-2778
Mailing Address - Street 1:1705 GLASGOW ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-2175
Mailing Address - Country:US
Mailing Address - Phone:161-281-9277
Mailing Address - Fax:984-278-5424
Practice Address - Street 1:1705 GLASGOW ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2175
Practice Address - Country:US
Practice Address - Phone:612-819-2778
Practice Address - Fax:984-278-5424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-13
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173F00000XOther Service ProvidersSleep Specialist, PhDGroup - Single Specialty