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General NPI Number Information
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NPI Number | 1255149803
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Entity Type | Organization
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Legal Business Name | SUSAN CHU DDS PLLC
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Dates
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Enumeration Date | 12/27/2024
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Last Update Date | 12/27/2024
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Provider Practice Location Address
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Address Line | 280 HARDIE AVE SW STE 3
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City | RENTON
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State | WA
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Zip | 98057-5900
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Country | US
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Telephone | 425-430-0400
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Fax |
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Provider Business Mailing Address
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Address Line | 20535 NE 37TH WAY
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City | SAMMAMISH
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State | WA
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Zip | 98074-9329
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Country | US
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Telephone | 909-438-3879
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SUSAN HAN-LU CHU
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Credential | DDS
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Telephone | 909-438-3879
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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