Provider Demographics
NPI:1740726272
Name:WU, XIALEI
Entity type:Individual
Prefix:
First Name:XIALEI
Middle Name:
Last Name:WU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 SW 5TH CT
Mailing Address - Street 2:APT H206
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-2380
Mailing Address - Country:US
Mailing Address - Phone:206-372-4379
Mailing Address - Fax:
Practice Address - Street 1:600 SW 5TH CT
Practice Address - Street 2:APT H206
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-2380
Practice Address - Country:US
Practice Address - Phone:206-372-4379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-08
Last Update Date:2017-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 00024041225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist