Healthcare Provider Details

I. General information

NPI: 1407380884
Provider Name (Legal Business Name): LAI LAI KWOK D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2017
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11913 NE 195TH ST
BOTHELL WA
98011-3147
US

IV. Provider business mailing address

11913 NE 195TH ST
BOTHELL WA
98011-3147
US

V. Phone/Fax

Practice location:
  • Phone: 425-489-3100
  • Fax: 877-594-3100
Mailing address:
  • Phone: 425-489-3100
  • Fax: 877-594-3100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOP61031913
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: