1659353431 NPI number — MS. SHAO-TI LIU MEREDITH ARNP

Table of content: MS. SHAO-TI LIU MEREDITH ARNP (NPI 1659353431)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659353431 NPI number — MS. SHAO-TI LIU MEREDITH ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MEREDITH
Provider First Name:
SHAO-TI
Provider Middle Name:
LIU
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659353431
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/25/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 34036
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98124-1036
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-899-3292
Provider Business Mailing Address Fax Number:
425-899-3269

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8299 161ST AVE NE
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
REDMOND
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98052-3860
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-881-8813
Provider Business Practice Location Address Fax Number:
425-869-7201
Provider Enumeration Date:
11/16/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  AP30005426 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 9625666 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: ME2130 . This is a "BLUE SHIELD" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 134472 . This is a "LABOR & INDUSTRIES" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 500024666 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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