Provider Demographics
NPI:1619963543
Name:LIAO, XINSHENG MICHAEL (MD PHD)
Entity Type:Individual
Prefix:
First Name:XINSHENG
Middle Name:MICHAEL
Last Name:LIAO
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15823 SE 45TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-4547
Mailing Address - Country:US
Mailing Address - Phone:425-643-9602
Mailing Address - Fax:
Practice Address - Street 1:15823 SE 45TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-4547
Practice Address - Country:US
Practice Address - Phone:425-643-9602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-26
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00036160207RH0000X, 207RX0202X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8254450Medicaid
WA8254450Medicaid
H15029Medicare UPIN