Provider Demographics
NPI:1609044064
Name:LI, MICHAEL PAK TO (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:PAK TO
Last Name:LI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 6TH AVE STE 832
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-1833
Mailing Address - Country:US
Mailing Address - Phone:206-441-2505
Mailing Address - Fax:206-441-2508
Practice Address - Street 1:2200 6TH AVE STE 832
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-1833
Practice Address - Country:US
Practice Address - Phone:206-441-2505
Practice Address - Fax:206-441-2508
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-19
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00662700111N00000X
WACH60133937111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor