NPIMap

Organization Active NPI

Clive M Liu MD PLLC

  • Dermatology Physician
  • Bellevue, WA
National Provider Identifier
1598092751
Registry record updated Nov 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD00043691 Issued in WA
Legal business name
CLIVE M LIU MD PLLC
Practice address
1810 116TH Ave NE
Suite 100
Bellevue, WA 98004-3058
Phone
(425) 455-2275
Fax
(425) 455-1511
NPI assigned
Nov 9, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Clive Maopang Liu, M.D.NPI 1790793487
Title
Owner
Phone
(425) 455-2275

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X MD00043691 WA Primary

Addresses

Primary practice location

1810 116TH Ave NE
Suite 100
Bellevue, WA 98004-3058

Mailing address

1810 116TH Ave NE
Suite 100
Bellevue, WA 98004-3058
Phone (425) 455-2275

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091117000129 WA Part B Supplier - Clinic/Group Practice 1658419460 Receives reassigned benefits from 7 practitioners
Practice locations: Bellevue, WA

National Provider Directory

National Provider Directory

Locations

1810 116th Ave NE
Ste 100
Bellevue, WA 98004
Phone (425) 455-2275

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1257724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257724800000",
    "number": "1598092751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 116TH AVE NE",
            "address_2": "SUITE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043058",
            "telephone_number": "425-455-2275",
            "fax_number": "425-455-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 116TH AVE NE",
            "address_2": "SUITE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043058",
            "telephone_number": "425-455-2275",
            "fax_number": "425-455-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLIVE M LIU MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-09",
        "last_updated": "2009-11-09",
        "status": "A",
        "authorized_official_last_name": "LIU",
        "authorized_official_first_name": "CLIVE",
        "authorized_official_middle_name": "MAOPANG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-455-2275",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD00043691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.