Basic Information
| Provider Information | |||||||||
| NPI: | 1982832168 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LU | ||||||||
| FirstName: | MENG | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 6989 MAIL STOP 18913 | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972286989 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2068587000 | ||||||||
| FaxNumber: | 2068587050 | ||||||||
| Practice Location | |||||||||
| Address1: | 10330 MERIDIAN AVE N | ||||||||
| Address2: | SUITE 370 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981339451 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2065286000 | ||||||||
| FaxNumber: | 2065280014 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2009 | ||||||||
| LastUpdateDate: | 06/16/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 196028 | PA | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207W00000X | MD60465588 | WA | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.