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Individual

ANTHONY LO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
515 MINOR AVE., SUITE 240, SEATTLE, WA 98104-2133
(206) 386-9668
(206) 386-9544
Mailing address
805 MADISON ST, SUITE 901, SEATTLE, WA 98104-1172
(206) 264-8100

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
P206
HI
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
P000000325
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1001072
WA
01
225904
LABOR & INDUSTRY
WA
01
5891740001
DME
WA
01
6815LO
REGENCE
WA
01
P00461226
PALMETTO / RR MEDICARE
WA
Enumeration date
10/19/2006
Last updated
04/05/2016
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