Healthcare Provider Details

I. General information

NPI: 1417755687
Provider Name (Legal Business Name): LU LIU DAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2025
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2719 E MADISON ST STE 203
SEATTLE WA
98112-4752
US

IV. Provider business mailing address

6533 53RD AVE NE
SEATTLE WA
98115-7748
US

V. Phone/Fax

Practice location:
  • Phone: 206-568-7545
  • Fax:
Mailing address:
  • Phone: 206-427-4577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC61526172
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: