Provider Demographics
NPI:1225855315
Name:LI, LING LING
Entity type:Individual
Prefix:
First Name:LING LING
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 SW 7TH ST STE J
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-2361
Mailing Address - Country:US
Mailing Address - Phone:425-687-2707
Mailing Address - Fax:
Practice Address - Street 1:20 SW 7TH ST STE J
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-2361
Practice Address - Country:US
Practice Address - Phone:425-687-2707
Practice Address - Fax:206-309-9063
Is Sole Proprietor?:No
Enumeration Date:2024-09-20
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60549005225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist