Provider Demographics
NPI:1821142431
Name:WU, DAN (LAC)
Entity Type:Individual
Prefix:
First Name:DAN
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:DAN
Other - Last Name:WU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC
Mailing Address - Street 1:1811 156 AVE NE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007
Mailing Address - Country:US
Mailing Address - Phone:425-643-3758
Mailing Address - Fax:425-643-9364
Practice Address - Street 1:1811 156 AVE NE
Practice Address - Street 2:SUITE 7
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007
Practice Address - Country:US
Practice Address - Phone:425-643-3758
Practice Address - Fax:425-643-9364
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00000342171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist