Healthcare Provider Details

I. General information

NPI: 1528923828
Provider Name (Legal Business Name): EAGLE WINGS DRIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9013 SILVERSPOT DR SE
TUMWATER WA
98501-5575
US

IV. Provider business mailing address

9013 SILVERSPOT DR SE
TUMWATER WA
98501-5575
US

V. Phone/Fax

Practice location:
  • Phone: 425-777-5666
  • Fax:
Mailing address:
  • Phone: 425-777-5666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: QUAN WEI LIU
Title or Position: OWNER
Credential: N.A.
Phone: 425-777-5666