Basic Information
| Provider Information | |||||||||
| NPI: | 1578096863 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | XU | ||||||||
| FirstName: | CASSIE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3209 S 23RD ST | ||||||||
| Address2: | STE 200 | ||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984051602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2532725127 | ||||||||
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| Practice Location | |||||||||
| Address1: | 33915 1ST WAY S STE 203 | ||||||||
| Address2: | |||||||||
| City: | FEDERAL WAY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980036396 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2538389839 | ||||||||
| FaxNumber: | 2536619077 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/04/2017 | ||||||||
| LastUpdateDate: | 08/18/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0102X | DR.0066609 | CO | N | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology | 207ZP0102X | MD61264545 | WA | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
No ID Information.