Healthcare Provider Details

I. General information

NPI: 1497691018
Provider Name (Legal Business Name): MENGMENG CAI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23530 43RD DR SE
BOTHELL WA
98021-9155
US

IV. Provider business mailing address

23530 43RD DR SE
BOTHELL WA
98021-9155
US

V. Phone/Fax

Practice location:
  • Phone: 765-476-3482
  • Fax:
Mailing address:
  • Phone: 765-476-3482
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number1238993
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: