Provider Demographics
NPI:1427231323
Name:LIAW, GENE S J (MD)
Entity Type:Individual
Prefix:DR
First Name:GENE
Middle Name:S J
Last Name:LIAW
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 1:662A S. JACKSON ST.
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104
Mailing Address - Country:US
Mailing Address - Phone:206-623-0733
Mailing Address - Fax:206-623-1014
Practice Address - Street 1:662 S JACKSON ST
Practice Address - Street 2:UNIT A
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2929
Practice Address - Country:US
Practice Address - Phone:206-623-0733
Practice Address - Fax:206-623-1014
Is Sole Proprietor?:No
Enumeration Date:2007-12-13
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00022484208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8801038Medicare PIN