Healthcare Provider Details

I. General information

NPI: 1942753959
Provider Name (Legal Business Name): JENNIFER LIU LMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2016
Last Update Date: 07/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 106TH AVE NE APT 407
BELLEVUE WA
98004-4387
US

IV. Provider business mailing address

1100 106TH AVE NE APT 407
BELLEVUE WA
98004-4387
US

V. Phone/Fax

Practice location:
  • Phone: 206-291-5887
  • Fax:
Mailing address:
  • Phone: 206-291-5887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: