Provider Demographics
NPI:1861545477
Name:ZHU, FENGSHAN (L, AC, OMD,)
Entity type:Individual
Prefix:DR
First Name:FENGSHAN
Middle Name:
Last Name:ZHU
Suffix:
Gender:M
Credentials:L, AC, OMD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 150TH PL NE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-5059
Mailing Address - Country:US
Mailing Address - Phone:425-746-0996
Mailing Address - Fax:206-748-5168
Practice Address - Street 1:621 S WELLER ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2924
Practice Address - Country:US
Practice Address - Phone:206-748-5168
Practice Address - Fax:206-748-5168
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00000512171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist