Provider Demographics
NPI:1801953971
Name:XU, SHUREN (ACUPUNCTURIST)
Entity type:Individual
Prefix:
First Name:SHUREN
Middle Name:
Last Name:XU
Suffix:
Gender:M
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 23RD AVE SE
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98372-4528
Mailing Address - Country:US
Mailing Address - Phone:253-840-3688
Mailing Address - Fax:253-840-6068
Practice Address - Street 1:115 23RD AVE SE
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-4528
Practice Address - Country:US
Practice Address - Phone:253-840-3688
Practice Address - Fax:253-840-6068
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00000660171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist