Healthcare Provider Details

I. General information

NPI: 1558079236
Provider Name (Legal Business Name): MEILING LIU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2022
Last Update Date: 11/10/2022
Certification Date: 11/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12505 NE BEL RED RD STE 112
BELLEVUE WA
98005-2510
US

IV. Provider business mailing address

12505 NE BEL RED RD STE 112
BELLEVUE WA
98005-2510
US

V. Phone/Fax

Practice location:
  • Phone: 425-484-9023
  • Fax: 206-309-9063
Mailing address:
  • Phone: 425-484-9023
  • Fax: 206-309-9063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number61254454
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: