Provider Demographics
NPI:1679666333
Name:EDDIE P LO DPM AND NATALIE T CHU DPM PLLC
Entity type:Organization
Organization Name:EDDIE P LO DPM AND NATALIE T CHU DPM PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:P
Authorized Official - Last Name:LO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:253-572-4848
Mailing Address - Street 1:2302 S UNION AVE STE B18
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1333
Mailing Address - Country:US
Mailing Address - Phone:253-572-4848
Mailing Address - Fax:253-572-1803
Practice Address - Street 1:2302 S UNION AVE STE B18
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1333
Practice Address - Country:US
Practice Address - Phone:253-572-4848
Practice Address - Fax:253-572-1803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPO00000633213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA480026920OtherMEDICARE RAILROAD
WA215605OtherLABOR AND INDUSTIES
WA7136294Medicaid
WADF9966OtherMEDICARE RAILROAD
WA5197EDOtherREGENCE GROUP RIDER
WA1106012Medicaid
WA1106822Medicaid
WA480028963OtherMEDICARE RAILROAD
WA5207100001OtherDMEPOS
WA1106822Medicaid
WA5197EDOtherREGENCE GROUP RIDER
WA5207100001OtherDMEPOS
WAG8862901Medicare UPIN
WAAB08264Medicare ID - Type UnspecifiedNATALIE T CHU, DPM
WA480028963OtherMEDICARE RAILROAD
WAAB06270Medicare ID - Type UnspecifiedEDDIE P LO, DPM