| Chu Clinic Llc | |
|
4713 168th St Sw Ste 105 Lynnwood WA 98037-6813 | |
| (425) 743-7000 | |
| (425) 743-7373 |
| Full Name | Chu Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4713 168th St Sw Ste 105, Lynnwood, Washington |
| Authorized Official Name and Position | Sunghae Chu (OFFICE MANAGER) |
| Authorized Official Contact | 4257437000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chu Clinic Llc 4713 168th St Sw Ste 105 Lynnwood WA 98037-6813 Ph: (425) 743-7000 | Chu Clinic Llc 4713 168th St Sw Ste 105 Lynnwood WA 98037-6813 Ph: (425) 743-7000 |
| NPI Number | 1578043980 |
|---|---|
| Provider Enumeration Date | 08/15/2018 |
| Last Update Date | 02/28/2020 |
| Medicare PECOS PAC ID | 8729332069 |
|---|---|
| Medicare Enrollment ID | O20190328002340 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578043980 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (Washington) | Primary |
| Provider Name | Samuel I Chu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245322700 PECOS PAC ID: 1052209848 Enrollment ID: I20050415000199 |
| Provider Name | Yeojin Jeong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952972275 PECOS PAC ID: 8224493713 Enrollment ID: I20230505002217 |
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