Individual
FREDRIC T LO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
34515 9TH AVENUE SOUTH, FEDERAL WAY, WA 98003-6761
(253) 952-7971
(253) 944-7922
Mailing address
505 S 336TH ST, SUITE 600, FEDERAL WAY, WA 98003-6328
(253) 838-6180
(253) 838-6418
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD00026725
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0171299
LIWA
WA
05
—
8120941
—
WA
01
—
LO1176
BSWA
WA
01
—
LO6879
BSWA
WA
Enumeration date
06/21/2006
Last updated
02/28/2008
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