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General NPI Number Information
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NPI Number | 1487001723
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Entity Type | Individual
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Provider Name | LIO MALUCHI RYU PA-C
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Gender | Male
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Dates
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Enumeration Date | 05/17/2016
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 1229 MADISON ST STE 1660
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City | SEATTLE
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State | WA
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Zip | 98104-3586
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Country | US
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Telephone | 206-329-1760
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5127
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City | EVERETT
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State | WA
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Zip | 98206-5127
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Country | US
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Telephone | 206-860-5414
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Fax | 206-720-8462
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA60783018
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License Number State | WA
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