Healthcare Provider Details
I. General information
NPI: 1649063439
Provider Name (Legal Business Name): XIAOQIN LIANG MA 60524345
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/26/2025
Last Update Date: 05/26/2025
Certification Date: 05/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
19827 3RD AVE SE
BOTHELL WA
98012-6273
US
IV. Provider business mailing address
12729 NORTHUP WAY STE 1
BELLEVUE WA
98005-1935
US
V. Phone/Fax
- Phone: 425-598-9829
- Fax:
- Phone: 206-468-8667
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | 60524345 |
| License Number State | WA |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: