Healthcare Provider Details

I. General information

NPI: 1275704637
Provider Name (Legal Business Name): HONG ZHU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2008
Last Update Date: 03/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2635 SW 335TH CT
FEDERAL WAY WA
98023-2853
US

IV. Provider business mailing address

2635 SW 335TH CT
FEDERAL WAY WA
98023-2853
US

V. Phone/Fax

Practice location:
  • Phone: 253-838-6468
  • Fax: 253-838-6438
Mailing address:
  • Phone: 253-838-6468
  • Fax: 253-838-6438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number410501
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: