Individual
THEODORE LAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1802 YAKIMA AVE STE 307, TACOMA, WA 98405-5305
(253) 627-1244
(253) 627-3520
Mailing address
1802 YAKIMA AVE STE 307, TACOMA, WA 98405-5305
(253) 627-1244
(253) 627-3520
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD00041200
WA
207RC0000X
Cardiovascular Disease Physician
MD00041200
WA
207RI0011X
Interventional Cardiology Physician
Primary
MD00041200
WA
207UN0901X
Nuclear Cardiology Physician
MD00041200
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0168601
DEPARTMENT OF L&I
WA
05
—
1004592
—
WA
01
—
1300LA
REGENCE
WA
01
—
1708LA
REGENCE
WA
01
—
1802LA
REGENCE
WA
01
—
4751LA
REGENCE
WA
01
—
P00008350
RAILROAD MEDICARE
WA
Enumeration date
01/11/2007
Last updated
09/15/2021
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