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General NPI Number Information
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NPI Number | 1093292385
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Entity Type | Individual
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Provider Name | CHARLES WENCHAO HU DDS
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Gender | Male
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Dates
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Enumeration Date | 07/19/2018
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Last Update Date | 09/18/2019
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Provider Practice Location Address
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Address Line | 17220 140TH AVE SE STE C
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City | RENTON
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State | WA
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Zip | 98058-7000
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Country | US
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Telephone | 425-270-8076
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Fax |
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Provider Business Mailing Address
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Address Line | 520 TERRY AVE UNIT 615
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City | SEATTLE
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State | WA
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Zip | 98104-2296
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Country | US
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Telephone | 626-203-5240
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DE60981432
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License Number State | WA
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