Healthcare Provider Details

I. General information

NPI: 1942784160
Provider Name (Legal Business Name): DAVID CUI PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2018
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14841 179TH AVE SE STE 330
MONROE WA
98272-1127
US

IV. Provider business mailing address

14841 179TH AVE SE STE 330
MONROE WA
98272-1127
US

V. Phone/Fax

Practice location:
  • Phone: 360-794-3300
  • Fax:
Mailing address:
  • Phone: 360-794-3300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA61006080
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: