Healthcare Provider Details

I. General information

NPI: 1013838804
Provider Name (Legal Business Name): SHIAO XU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 176TH ST E
SPANAWAY WA
98387-8335
US

IV. Provider business mailing address

12910 194TH AVENUE CT E
BONNEY LAKE WA
98391-6097
US

V. Phone/Fax

Practice location:
  • Phone: 253-800-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: