Individual
DR. KENNETH R WU
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
971 11TH AVE, LONGVIEW, WA 98632-2503
(360) 423-6140
(360) 423-1405
Mailing address
971 11TH AVE, LONGVIEW, WA 98632-2503
(360) 423-6140
(360) 423-1405
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD00045359
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8440570
—
WA
Enumeration date
04/21/2006
Last updated
07/08/2007
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