Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | MD00040633 | WA |
N | 207QS0010X | Family Doctor - Sports Medicine | MD00040633 | WA |
NPI | 1265455612 |
---|---|
Provider Name | Wuaca K Luna |
First Address | Renton, WA 98055-4934 |
Second Address | Renton, WA 98055-5772 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 03/04/2015 |