Provider Demographics
NPI:1992021091
Name:TU, ALLEN S (PAC)
Entity type:Individual
Prefix:
First Name:ALLEN
Middle Name:S
Last Name:TU
Suffix:
Gender:
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8564 SIENA CT
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:WA
Mailing Address - Zip Code:98230-6602
Mailing Address - Country:US
Mailing Address - Phone:765-427-7775
Mailing Address - Fax:
Practice Address - Street 1:2 EMBARCADERO CTR LBBY LEVEL
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111-3823
Practice Address - Country:US
Practice Address - Phone:415-578-3100
Practice Address - Fax:415-252-7176
Is Sole Proprietor?:No
Enumeration Date:2010-04-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA59493363A00000X
363A00000X
WAPA60135305363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8916312Medicare Oscar/Certification
WAG8916311Medicare Oscar/Certification