Provider Demographics
NPI:1922482389
Name:LI, LIJIE
Entity Type:Individual
Prefix:
First Name:LIJIE
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9301 LINDER WAY NW
Mailing Address - Street 2:101
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8396
Mailing Address - Country:US
Mailing Address - Phone:425-249-8608
Mailing Address - Fax:
Practice Address - Street 1:9301 LINDER WAY NW
Practice Address - Street 2:101
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8396
Practice Address - Country:US
Practice Address - Phone:360-692-7000
Practice Address - Fax:360-698-4699
Is Sole Proprietor?:No
Enumeration Date:2015-07-16
Last Update Date:2023-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60460122171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist