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General NPI Number Information
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NPI Number | 1326390303
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Entity Type | Organization
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Legal Business Name | PAUL LUU PS INC
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Dates
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Enumeration Date | 10/15/2012
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Last Update Date | 10/15/2012
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Provider Practice Location Address
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Address Line | 5420 RAINIER AVE. S
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City | SEATTLE
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State | WA
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Zip | 98118
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Country | US
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Telephone | 206-723-2889
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Fax | 206-723-4939
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Provider Business Mailing Address
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Address Line | 5420 RAINIER AVE. S
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City | SEATTLE
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State | WA
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Zip | 98118
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Country | US
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Telephone | 206-723-2889
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Fax | 206-723-4939
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Authorized Official
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Title or Position | CEO
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Name | PAUL LUU
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Credential | M.D.
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Telephone | 206-723-2889
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | MD00032942
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License Number State | WA
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