Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | MD60681515 | WA |
NPI | 1013271568 |
---|---|
Provider Name | Dr. Fan Liu |
First Address | Seattle, WA 98145-5095 |
Second Address | Seattle, WA 98105-6099 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2012 |
Last Update Date | 20/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1013271568 | (05) | WA |