Healthcare Provider Details
I. General information
NPI: 1821734765
Provider Name (Legal Business Name): JIULIN ZHU PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/11/2022
Last Update Date: 07/18/2022
Certification Date: 07/18/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
37624 SE FURY ST STE 200
SNOQUALMIE WA
98065-9680
US
IV. Provider business mailing address
37624 SE FURY ST STE 200
SNOQUALMIE WA
98065-9680
US
V. Phone/Fax
- Phone: 425-292-9230
- Fax: 425-292-9239
- Phone: 917-386-5212
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QD0000X |
| Taxonomy | Dental Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JIULIN
ZHU
Title or Position: OWNER DENTIST
Credential: DDS
Phone: 917-386-5212