Healthcare Provider Details

I. General information

NPI: 1922567205
Provider Name (Legal Business Name): QI YING MCCLELLAND MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: QI YING LI

II. Dates (important events)

Enumeration Date: 03/17/2019
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 S PIONEER WAY
MOSES LAKE WA
98837-4613
US

IV. Provider business mailing address

660 S COOLIDGE ST
MOSES LAKE WA
98837-1872
US

V. Phone/Fax

Practice location:
  • Phone: 509-793-9792
  • Fax: 509-764-3287
Mailing address:
  • Phone: 509-793-9715
  • Fax: 509-764-3244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD61493242
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: