Provider Demographics
NPI:1861860280
Name:WU, CHRISTINE (DDS)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1511 NE HAWTHORNE ST
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98029-7642
Mailing Address - Country:US
Mailing Address - Phone:206-403-3827
Mailing Address - Fax:
Practice Address - Street 1:10212 5TH AVE NE STE 268
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-7495
Practice Address - Country:US
Practice Address - Phone:206-527-5111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-02
Last Update Date:2016-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60574179122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist