Basic Information
| Provider Information | |||||||||
| NPI: | 1619395738 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LUO | ||||||||
| FirstName: | JING | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 19020 33RD AVE W STE 210 | ||||||||
| Address2: | |||||||||
| City: | LYNNWOOD | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980364748 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4255631500 | ||||||||
| FaxNumber: | 4255631374 | ||||||||
| Practice Location | |||||||||
| Address1: | 201 16TH AVE E | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981125226 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2063263000 | ||||||||
| FaxNumber: | 2063262785 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/04/2014 | ||||||||
| LastUpdateDate: | 04/14/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | MD60675882 | WA | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 0425499 | 01 | WA | L&I-VANCOUVER RADIOLOGY | OTHER | 0425490 | 01 | WA | L&I-RADIA REST OF WA | OTHER | 0425491 | 01 | WA | L&I-RADIA KING CTY | OTHER | 0425496 | 01 | WA | L&I-SOUTH SOUND RADIOLOGY | OTHER | 0425498 | 01 | WA | L&I-SEATTLE RADIOLOGY | OTHER | 2045547 | 05 | WA | MEDICAID | 0425492 | 01 | WA | L&I-SWEDISH RADIA EDMONDS | OTHER | 0425494 | 01 | WA | L&I-EVERGREEN RADIA | OTHER |