Individual
LULU M. GIZAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
325 9TH AVE, SEATTLE, WA 98104-2499
(206) 744-3000
Mailing address
2100 POWELL ST, STE 900, EMERYVILLE, CA 94608-1844
(510) 851-7423
(510) 879-9120
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA10004354
WA
363AM0700X
Medical Physician Assistant
Primary
PA10004354
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0177140
L&I PIN
WA
01
—
25733U
REGENCE BLUE SHIELD PIN
WA
05
—
8358418
—
WA
Enumeration date
07/31/2006
Last updated
07/25/2016
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