Provider Demographics
NPI:1245728674
Name:SHYUE, CHRISTOPHER (DDS)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:SHYUE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 12TH ST SE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:WA
Mailing Address - Zip Code:98631-2665
Mailing Address - Country:US
Mailing Address - Phone:360-642-3751
Mailing Address - Fax:
Practice Address - Street 1:205 12TH ST SE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:WA
Practice Address - Zip Code:98631-2665
Practice Address - Country:US
Practice Address - Phone:360-642-3751
Practice Address - Fax:360-642-7142
Is Sole Proprietor?:No
Enumeration Date:2018-05-01
Last Update Date:2025-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60861775122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2103975Medicaid