Provider Demographics
NPI:1285111328
Name:YU, DONG (DPM)
Entity type:Individual
Prefix:
First Name:DONG
Middle Name:
Last Name:YU
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 188TH ST SW STE 110
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-4757
Mailing Address - Country:US
Mailing Address - Phone:425-778-5666
Mailing Address - Fax:425-771-5374
Practice Address - Street 1:3500 188TH ST SW STE 110
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98037-4757
Practice Address - Country:US
Practice Address - Phone:425-778-5666
Practice Address - Fax:425-771-5374
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-22
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPO61237766213E00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty