MEDICARE: PATRICIA MU DMD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	6431	WA

General Provider Information

NPI Number	:	1083832331
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATRICIA MU DMD PC

Provider Business Mailing Address
First Line	:	16510 CLEVELAND ST STE Q
Second Line	:
City	:	REDMOND
State	:	WA
Zip	:	98052-4439
Country	:	US
Telephone Number	:	425-882-1112
Fax Number	:	425-883-8292

Provider Business Practice Location Address
First Line	:	16510 CLEVELAND ST STE Q
Second Line	:
City	:	REDMOND
State	:	WA
Zip	:	98052-4439
Country	:	US
Telephone Number	:	425-882-1112
Fax Number	:	425-883-8292

Authorized Official
Title or Position	:	OWNER DENTIST
Name	:	DR. MAY-CHU PATRICIA MU
Credential	:	D.M.D.
Telephone Number	:	425-882-1112

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	01/29/2010

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