Provider Demographics
NPI:1457621286
Name:WU, FENFEN (MD)
Entity Type:Individual
Prefix:MRS
First Name:FENFEN
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34503 9TH AVE S
Mailing Address - Street 2:STE 100
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-8727
Mailing Address - Country:US
Mailing Address - Phone:253-874-2227
Mailing Address - Fax:253-835-8000
Practice Address - Street 1:34503 9TH AVE S
Practice Address - Street 2:STE 100
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-8727
Practice Address - Country:US
Practice Address - Phone:253-874-2227
Practice Address - Fax:253-835-8000
Is Sole Proprietor?:No
Enumeration Date:2012-01-10
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60454662207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine