Healthcare Provider Details

I. General information

NPI: 1851705743
Provider Name (Legal Business Name): MANDY YEE-MEI LIU RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2014
Last Update Date: 07/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 NE 4TH ST
RENTON WA
98059-5008
US

IV. Provider business mailing address

4300 NE 4TH ST
RENTON WA
98059-5008
US

V. Phone/Fax

Practice location:
  • Phone: 425-235-6251
  • Fax:
Mailing address:
  • Phone: 425-235-6251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH 60419038
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: