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General NPI Number Information
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NPI Number | 1124317201
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Entity Type | Organization
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Legal Business Name | SHUWEN LISA LU, DDS, PLLC
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Dates
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Enumeration Date | 03/29/2011
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Last Update Date | 03/29/2011
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Provider Practice Location Address
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Address Line | 3325 SMOKEY POINT DR SUITE 204
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City | ARLINGTON
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State | WA
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Zip | 98223-7803
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Country | US
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Telephone | 360-618-0176
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Fax | 206-577-3860
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Provider Business Mailing Address
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Address Line | 26239 104TH AVE SE
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City | KENT
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State | WA
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Zip | 98030-7672
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Country | US
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Telephone | 360-618-0176
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Fax | 206-577-3860
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Authorized Official
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Title or Position | DENTIST
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Name | DR. SHUWEN LU
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Credential | DDS
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Telephone | 360-618-0176
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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 | DE00010683
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License Number State | WA
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