Provider Demographics
NPI:1205161700
Name:LU, STANLEE SANTOS (MD)
Entity type:Individual
Prefix:MR
First Name:STANLEE
Middle Name:SANTOS
Last Name:LU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 PACIFIC HWY E STE 100
Mailing Address - Street 2:
Mailing Address - City:FIFE
Mailing Address - State:WA
Mailing Address - Zip Code:98424-1160
Mailing Address - Country:US
Mailing Address - Phone:253-382-6300
Mailing Address - Fax:253-382-6301
Practice Address - Street 1:3700 PACIFIC HWY E STE 100
Practice Address - Street 2:
Practice Address - City:FIFE
Practice Address - State:WA
Practice Address - Zip Code:98424
Practice Address - Country:US
Practice Address - Phone:253-382-6300
Practice Address - Fax:253-382-6301
Is Sole Proprietor?:No
Enumeration Date:2009-10-16
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60315272207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2026972Medicaid