Healthcare Provider Details

I. General information

NPI: 1790513489
Provider Name (Legal Business Name): SIJING HAO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2024
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12220 113TH AVE NE STE 120
KIRKLAND WA
98034-6950
US

IV. Provider business mailing address

12220 113TH AVE NE STE 120
KIRKLAND WA
98034-6950
US

V. Phone/Fax

Practice location:
  • Phone: 425-295-7697
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC.LH.70116731
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: