Provider Demographics
NPI:1780106492
Name:WU, PETER XIHUA (OD)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:XIHUA
Last Name:WU
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5023 E MERCER WAY
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-4739
Mailing Address - Country:US
Mailing Address - Phone:206-817-8892
Mailing Address - Fax:
Practice Address - Street 1:2715 CALIFORNIA AVE SW APT 110A
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-2563
Practice Address - Country:US
Practice Address - Phone:206-817-8892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-13
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60769332152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist