Provider Demographics
NPI:1619706504
Name:DONG WU HAN PLLC
Entity type:Organization
Organization Name:DONG WU HAN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHELSEA
Authorized Official - Middle Name:
Authorized Official - Last Name:NUEVO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-301-6112
Mailing Address - Street 1:16108 ASH WAY STE 202
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98087-8781
Mailing Address - Country:US
Mailing Address - Phone:425-741-2030
Mailing Address - Fax:
Practice Address - Street 1:16108 ASH WAY STE 202
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98087-8781
Practice Address - Country:US
Practice Address - Phone:425-741-2030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty