Healthcare Provider Details

I. General information

NPI: 1184203325
Provider Name (Legal Business Name): JUN WU L. AC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18008 BOTHELL EVERETT HWY STE F
BOTHELL WA
98012-6842
US

IV. Provider business mailing address

3119 183RD ST SE
BOTHELL WA
98012-9349
US

V. Phone/Fax

Practice location:
  • Phone: 872-888-3833
  • Fax:
Mailing address:
  • Phone: 872-888-3833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC61132525
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: