Healthcare Provider Details

I. General information

NPI: 1770420523
Provider Name (Legal Business Name): LI LI ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3503 NORFOLK CT SE
OLYMPIA WA
98501-7021
US

IV. Provider business mailing address

3503 NORFOLK CT SE
OLYMPIA WA
98501-7021
US

V. Phone/Fax

Practice location:
  • Phone: 218-248-0074
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP.AP.70125390-NP
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: