Healthcare Provider Details

I. General information

NPI: 1407381759
Provider Name (Legal Business Name): YUXUAN HU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2017
Last Update Date: 05/16/2024
Certification Date: 05/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 LILLY RD NE STE 100
OLYMPIA WA
98506-5195
US

IV. Provider business mailing address

PO BOX 3360
PORTLAND OR
97208-3360
US

V. Phone/Fax

Practice location:
  • Phone: 360-413-8525
  • Fax: 360-412-6477
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD61548517
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: