=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083191290
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | XIUFEN LU LMP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/20/2018
-----------------------------------------------------
Last Update Date | 07/20/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 18421 HIGHWAY 99 STE G
-----------------------------------------------------
City | LYNNWOOD
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98037-4457
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 425-582-9951
-----------------------------------------------------
Fax | 425-582-9954
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4214 166TH PL SW
-----------------------------------------------------
City | LYNNWOOD
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98037-9028
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-356-3471
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number | MA60810098
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------