Healthcare Provider Details

I. General information

NPI: 1487900833
Provider Name (Legal Business Name): CHARLIE CHUN HSU VMD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2012
Last Update Date: 08/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST BOX 357190, HEALTH SCIENCES CENTER
SEATTLE WA
98195-7190
US

IV. Provider business mailing address

1959 NE PACIFIC ST BOX 357190, HEALTH SCIENCES CENTER
SEATTLE WA
98195-7190
US

V. Phone/Fax

Practice location:
  • Phone: 206-543-0474
  • Fax: 206-685-3006
Mailing address:
  • Phone: 206-543-0474
  • Fax: 206-685-3006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License NumberVT60281917
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code174MM1900X
TaxonomyMedical Research Veterinarian
License NumberVT60281917
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: