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General NPI Number Information
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NPI Number | 1043723364
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Entity Type | Individual
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Provider Name | XUE LI
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Gender | Female
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Dates
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Enumeration Date | 11/08/2017
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Last Update Date | 11/08/2017
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Provider Practice Location Address
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Address Line | 8629 120TH AVE NE
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City | KIRKLAND
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State | WA
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Zip | 98033-5822
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Country | US
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Telephone | 425-827-1693
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Fax |
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Provider Business Mailing Address
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Address Line | 8807 NE 147TH LN
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City | KENMORE
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State | WA
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Zip | 98028-4773
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Country | US
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Telephone | 425-785-2084
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 60799846
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License Number State | WA
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