Provider Demographics
NPI:1992849129
Name:LUU, HUONG THE (MD)
Entity Type:Individual
Prefix:DR
First Name:HUONG
Middle Name:THE
Last Name:LUU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:12004 NE FOURTH PLAIN RD STE G
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682-5564
Mailing Address - Country:US
Mailing Address - Phone:360-260-9736
Mailing Address - Fax:360-260-8326
Practice Address - Street 1:12004 NE FOURTH PLAIN RD STE G
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98682-5564
Practice Address - Country:US
Practice Address - Phone:360-260-9736
Practice Address - Fax:360-260-8326
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA30582207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8158248Medicaid
WA8158248Medicaid