Healthcare Provider Details

I. General information

NPI: 1811817554
Provider Name (Legal Business Name): KAI HE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19316 BOTHELL WAY NE
BOTHELL WA
98011-6022
US

IV. Provider business mailing address

JINTANG RD LANE 155 NO. 14 ROOM 1102
SHANGHAI SHANGHAI
200333
CN

V. Phone/Fax

Practice location:
  • Phone: 206-619-9267
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSYC.PY.70064378
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: