Provider Demographics
NPI:1316225113
Name:LI, JIHUI (MD)
Entity Type:Individual
Prefix:
First Name:JIHUI
Middle Name:
Last Name:LI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3003 TIETON DR STE 300
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-3686
Mailing Address - Country:US
Mailing Address - Phone:509-575-3946
Mailing Address - Fax:
Practice Address - Street 1:3003 TIETON DR STE 300
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3686
Practice Address - Country:US
Practice Address - Phone:509-575-3946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-27
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036136120208600000X
WAMD61161985208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2193670Medicaid