Provider Demographics
NPI:1932317898
Name:LUI, JENNIFER
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:LUI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22626 NE INGLEWOOD HILL RD
Mailing Address - Street 2:APARTMENT #1033
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98074-5003
Mailing Address - Country:US
Mailing Address - Phone:206-799-8565
Mailing Address - Fax:
Practice Address - Street 1:22626 NE INGLEWOOD HILL ROAD
Practice Address - Street 2:APARTMENT #1033
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98074-5003
Practice Address - Country:US
Practice Address - Phone:206-799-8565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6514225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant