Provider Demographics
NPI:1205905601
Name:HSU, RAYMOND (DDS, MAGD)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:
Last Name:HSU
Suffix:
Gender:M
Credentials:DDS, MAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16150 NE 85TH ST
Mailing Address - Street 2:SUITE 115
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3539
Mailing Address - Country:US
Mailing Address - Phone:425-882-1354
Mailing Address - Fax:425-883-3141
Practice Address - Street 1:16150 NE 85TH ST
Practice Address - Street 2:SUITE 115
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3539
Practice Address - Country:US
Practice Address - Phone:425-882-1354
Practice Address - Fax:425-883-3141
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA58381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice