Provider Demographics
NPI:1922817949
Name:PANDURU, IOANA DANIELA (LACEMP)
Entity type:Individual
Prefix:
First Name:IOANA
Middle Name:DANIELA
Last Name:PANDURU
Suffix:
Gender:F
Credentials:LACEMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2582 UNION AVE NE
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98059-3501
Mailing Address - Country:US
Mailing Address - Phone:425-442-2612
Mailing Address - Fax:
Practice Address - Street 1:4307 FACTORIA BLVD SE STE 2
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-1936
Practice Address - Country:US
Practice Address - Phone:425-698-0760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-03
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC61638949171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist