Provider Demographics
NPI:1184080442
Name:LIU, WAYNA HEIDI (PA)
Entity type:Individual
Prefix:
First Name:WAYNA
Middle Name:HEIDI
Last Name:LIU
Suffix:
Gender:F
Credentials:PA
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Other - Credentials:
Mailing Address - Street 1:4225 E MCDOWELL RD
Mailing Address - Street 2:#3021
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-7475
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2950 S ALMA SCHOOL RD STE 1
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-8120
Practice Address - Country:US
Practice Address - Phone:480-827-5690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-01
Last Update Date:2018-04-05
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical