Provider Demographics
NPI:1588483150
Name:TIAN, JINGHUIZI (MSW)
Entity type:Individual
Prefix:
First Name:JINGHUIZI
Middle Name:
Last Name:TIAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:SANDY
Other - Middle Name:
Other - Last Name:TIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5108 196TH ST SW C/O RXDX MED BILLING SVC LLC
Mailing Address - Street 2:STE 310
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036
Mailing Address - Country:US
Mailing Address - Phone:425-582-2041
Mailing Address - Fax:
Practice Address - Street 1:5108 196TH ST SW STE 350
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-6169
Practice Address - Country:US
Practice Address - Phone:425-582-2041
Practice Address - Fax:425-527-0468
Is Sole Proprietor?:No
Enumeration Date:2024-10-09
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW61620235104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker