Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122400000X | Denturist | DN60271528 | WA |
NPI | 1588929988 |
---|---|
Provider Name | Yu Mark Wu |
First Address | Seattle, WA 98144-6331 |
Second Address | Seattle, WA 98144-6331 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2012 |
Last Update Date | 11/07/2012 |