Provider Demographics
NPI:1841687647
Name:KU, STEPHEN C (DO)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:C
Last Name:KU
Suffix:
Gender:M
Credentials:DO
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:UNIVERSITY OF WASHINGTON
Mailing Address - Street 2:1959 NE PACIFIC STREET, BOX 356540
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-6540
Mailing Address - Country:US
Mailing Address - Phone:206-543-2773
Mailing Address - Fax:
Practice Address - Street 1:314 MARTIN LUTHER KING JR WAY STE 300
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4292
Practice Address - Country:US
Practice Address - Phone:253-274-1668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-20
Last Update Date:2020-02-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAOP60759505207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology