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General NPI Number Information
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NPI Number | 1629820048
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Entity Type | Individual
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Provider Name | BETHANY LI OD
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Gender | Female
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Dates
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Enumeration Date | 04/02/2024
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 1412 SW 43RD ST STE 310
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City | RENTON
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State | WA
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Zip | 98057-4803
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Country | US
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Telephone | 425-235-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 14614 97TH AVE NE
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City | BOTHELL
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State | WA
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Zip | 98011-7270
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Country | US
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Telephone | 206-446-2817
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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 | 61550315
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License Number State | WA
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