Provider Demographics
NPI:1609397736
Name:LI, MEI TAK (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MEI TAK
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:HEIDI
Other - Middle Name:
Other - Last Name:LI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:1410 NE CAMPUS PKWY BOX 355830 SCHMITZ HALL 401
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-0001
Mailing Address - Country:US
Mailing Address - Phone:626-726-1367
Mailing Address - Fax:
Practice Address - Street 1:1410 NE CAMPUS PKWY
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-0003
Practice Address - Country:US
Practice Address - Phone:206-543-1240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-28
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33389103TC0700X
WAPY61243862103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical