Provider Demographics
NPI:1497040620
Name:XIAO, QIANG (LMP)
Entity type:Individual
Prefix:
First Name:QIANG
Middle Name:
Last Name:XIAO
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11516 124TH AVE NE
Mailing Address - Street 2:SUITE CB
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-4643
Mailing Address - Country:US
Mailing Address - Phone:425-968-8661
Mailing Address - Fax:425-377-8272
Practice Address - Street 1:11516 124TH AVE NE
Practice Address - Street 2:SUITE CB
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-4643
Practice Address - Country:US
Practice Address - Phone:425-968-8661
Practice Address - Fax:425-377-8272
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-15
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60168789225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist