Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP60582491 | WA |
NPI | 1003290073 |
---|---|
Provider Name | Ms. Xuemei Su |
First Address | Bellevue, WA 98006-3034 |
Second Address | Kirkland, WA 98034-3099 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2015 |
Last Update Date | 19/07/2015 |