Provider Demographics
NPI:1396931523
Name:YU, LIJUAN LESLIE (MD)
Entity type:Individual
Prefix:DR
First Name:LIJUAN
Middle Name:LESLIE
Last Name:YU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3529 NW SIERRA DR
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-7361
Mailing Address - Country:US
Mailing Address - Phone:360-210-7505
Mailing Address - Fax:360-210-7505
Practice Address - Street 1:11719 NE 95TH ST
Practice Address - Street 2:#F
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98682-2444
Practice Address - Country:US
Practice Address - Phone:360-896-3188
Practice Address - Fax:360-896-3122
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00046794208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics