Provider Demographics
NPI:1104352400
Name:LIANG, XIAO (PHARMD)
Entity type:Individual
Prefix:
First Name:XIAO
Middle Name:
Last Name:LIANG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3596 TACOMA AVE S
Mailing Address - Street 2:5
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98418-6849
Mailing Address - Country:US
Mailing Address - Phone:413-230-7311
Mailing Address - Fax:
Practice Address - Street 1:4025 DELRIDGE WAY SW
Practice Address - Street 2:400
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98106-1249
Practice Address - Country:US
Practice Address - Phone:206-763-2626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-04
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH.60724092183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist