Provider Demographics
NPI:1245085448
Name:LI, DEVIN (DO)
Entity type:Individual
Prefix:
First Name:DEVIN
Middle Name:
Last Name:LI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11311 214TH PL SE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98296-7102
Mailing Address - Country:US
Mailing Address - Phone:607-329-3430
Mailing Address - Fax:
Practice Address - Street 1:967 NORTH BROADWAY
Practice Address - Street 2:MEDICAL EDUCATION DEPART.
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701
Practice Address - Country:US
Practice Address - Phone:914-798-8971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program