Provider Demographics
NPI:1124837190
Name:ADU, LORETTA
Entity type:Individual
Prefix:MS
First Name:LORETTA
Middle Name:
Last Name:ADU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13213 AMBAUM BLVD SW APT 203
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98146-3231
Mailing Address - Country:US
Mailing Address - Phone:206-822-1795
Mailing Address - Fax:
Practice Address - Street 1:11900 BEACON AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98178-2811
Practice Address - Country:US
Practice Address - Phone:206-772-6900
Practice Address - Fax:206-772-6566
Is Sole Proprietor?:No
Enumeration Date:2025-01-04
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician