1992184204 NPI number — MRS. JU-YI FU LMHC

Table of content: MRS. JU-YI FU LMHC (NPI 1992184204)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992184204 NPI number — MRS. JU-YI FU LMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FU
Provider First Name:
JU-YI
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LMHC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
REYNOLDS
Provider Other First Name:
JOYCE
Provider Other Middle Name:
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMHC
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1992184204
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/29/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1611
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
POULSBO
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98370-0197
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-697-1141
Provider Business Mailing Address Fax Number:
360-697-2395

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20174 FRONT ST NE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
POULSBO
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98370-7445
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-697-1141
Provider Business Practice Location Address Fax Number:
360-697-2395
Provider Enumeration Date:
05/20/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  LH60691400 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)