Healthcare Provider Details

I. General information

NPI: 1083971238
Provider Name (Legal Business Name): YUNG-TING HSU DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2012
Last Update Date: 06/26/2020
Certification Date: 06/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST # D-554
SEATTLE WA
98195-7444
US

IV. Provider business mailing address

1959 NE PACIFIC ST # D-554
SEATTLE WA
98195-7444
US

V. Phone/Fax

Practice location:
  • Phone: 734-389-9818
  • Fax: 206-616-7478
Mailing address:
  • Phone: 734-389-9818
  • Fax: 206-616-7478

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberDE60960411
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: