Provider Demographics
NPI:1467459487
Name:LIU, KIMBERLY YU-YI (DO)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:YU-YI
Last Name:LIU
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 34036
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1036
Mailing Address - Country:US
Mailing Address - Phone:425-899-3292
Mailing Address - Fax:425-899-3269
Practice Address - Street 1:8980 161ST AVE NE
Practice Address - Street 2:SUITE 400
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-7554
Practice Address - Country:US
Practice Address - Phone:425-899-2273
Practice Address - Fax:425-899-2272
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00001932207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8405540Medicaid
WAI11045Medicare UPIN
WA8405540Medicaid
WAG8898573Medicare PIN
WA8805367Medicare ID - Type Unspecified
WAG8898574Medicare PIN