Healthcare Provider Details

I. General information

NPI: 1649406828
Provider Name (Legal Business Name): JAMES MING WU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2009
Last Update Date: 10/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 MARTIN LUTHER KING JR WAY
TACOMA WA
98405-4234
US

IV. Provider business mailing address

317 MARTIN LUTHER KING JR WAY
TACOMA WA
98405-4234
US

V. Phone/Fax

Practice location:
  • Phone: 253-403-1418
  • Fax:
Mailing address:
  • Phone: 253-403-1418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License NumberD0076097
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2010012757
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number94-07430
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License NumberMD60589263
License Number StateWA
# 5
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License NumberMD60589263
License Number StateWA
# 6
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD60589263
License Number StateWA
# 7
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD60589263
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: