Healthcare Provider Details

I. General information

NPI: 1174100853
Provider Name (Legal Business Name): STEPHAN HU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2021
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 MARTIN LUTHER KING JR WAY STE 408
TACOMA WA
98405-4261
US

IV. Provider business mailing address

316 MARTIN LUTHER KING JR WAY STE 408
TACOMA WA
98405-4261
US

V. Phone/Fax

Practice location:
  • Phone: 253-403-4554
  • Fax:
Mailing address:
  • Phone: 253-403-0344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD.MD.70127141
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: