Provider Demographics
NPI:1285062984
Name:LI, RUNLI
Entity type:Individual
Prefix:
First Name:RUNLI
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 1:13200 OLD REDMOND RD STE 130
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-1819
Mailing Address - Country:US
Mailing Address - Phone:425-786-8089
Mailing Address - Fax:
Practice Address - Street 1:13200 OLD REDMOND RD STE 130
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-1819
Practice Address - Country:US
Practice Address - Phone:425-786-8089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-16
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60240572172P00000X, 225700000X
WA60240572225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
No172P00000XOther Service ProvidersNaprapath