Healthcare Provider Details

I. General information

NPI: 1235308032
Provider Name (Legal Business Name): JAMES LIU D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2008
Last Update Date: 11/10/2020
Certification Date: 11/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1233 164TH ST SW STE H
LYNNWOOD WA
98087-8193
US

IV. Provider business mailing address

1233 164TH ST SW STE H
LYNNWOOD WA
98087-8193
US

V. Phone/Fax

Practice location:
  • Phone: 425-787-2402
  • Fax:
Mailing address:
  • Phone: 425-787-2402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDE00010177
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: