Healthcare Provider Details

I. General information

NPI: 1689082000
Provider Name (Legal Business Name): HSU & SHAO PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2014
Last Update Date: 07/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2709 BICKFORD AVE SUITE A
SNOHOMISH WA
98290-1766
US

IV. Provider business mailing address

2709 BICKFORD AVE SUITE A
SNOHOMISH WA
98290-1766
US

V. Phone/Fax

Practice location:
  • Phone: 425-374-8451
  • Fax: 425-374-8484
Mailing address:
  • Phone: 425-374-8451
  • Fax: 425-374-8484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number10544
License Number StateWA

VIII. Authorized Official

Name: DR. ANDY HSU
Title or Position: CO-OWNER
Credential: DMD
Phone: 206-355-8897