Healthcare Provider Details

I. General information

NPI: 1528693223
Provider Name (Legal Business Name): QIAN TU PHD, DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2020
Last Update Date: 05/05/2020
Certification Date: 05/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 N DIVISION ST STE 402
AUBURN WA
98001-4939
US

IV. Provider business mailing address

202 N DIVISION ST STE 402
AUBURN WA
98001-4939
US

V. Phone/Fax

Practice location:
  • Phone: 253-545-5870
  • Fax:
Mailing address:
  • Phone: 253-545-5870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP61057974
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60314457
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: