Healthcare Provider Details

I. General information

NPI: 1992634232
Provider Name (Legal Business Name): JIEYING LI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANINE LI

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417 E PIONEER STE B
PUYALLUP WA
98372-3267
US

IV. Provider business mailing address

417 E PIONEER STE B
PUYALLUP WA
98372-3267
US

V. Phone/Fax

Practice location:
  • Phone: 425-298-3128
  • Fax: 253-785-9945
Mailing address:
  • Phone: 425-298-3128
  • Fax: 253-785-9945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: