Provider Demographics
NPI:1659353431
Name:MEREDITH, SHAO-TI LIU (ARNP)
Entity Type:Individual
Prefix:MS
First Name:SHAO-TI
Middle Name:LIU
Last Name:MEREDITH
Suffix:
Gender:F
Credentials:ARNP
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 1:8299 161ST AVE NE
Practice Address - Street 2:SUITE 101
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3860
Practice Address - Country:US
Practice Address - Phone:425-881-8813
Practice Address - Fax:425-869-7201
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30005426363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9625666Medicaid
WAME2130OtherBLUE SHIELD
WA134472OtherLABOR & INDUSTRIES
WA500024666OtherMEDICARE RAILROAD
WAS92575Medicare UPIN
WA9625666Medicaid
WAG8897731Medicare PIN
WAME2130OtherBLUE SHIELD