Provider Demographics
NPI:1689070674
Name:LIU QUANWEI
Entity Type:Organization
Organization Name:LIU QUANWEI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:QUANWEI
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:MASSAGE PRACTITIONER
Authorized Official - Phone:425-687-2707
Mailing Address - Street 1:819 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-2737
Mailing Address - Country:US
Mailing Address - Phone:425-687-2707
Mailing Address - Fax:206-309-9063
Practice Address - Street 1:819 S 3RD ST
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-2737
Practice Address - Country:US
Practice Address - Phone:425-687-2707
Practice Address - Fax:206-309-9063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-18
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60479389225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMA60479389OtherMASSAGE PRACTITIONER LICENSE