Active NPI
Li Wang
- Specialist
- Bellevue, WA
National Provider Identifier
1841691144
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA 60491431
- Practice address
- 10657 NE 2ND St
Bellevue, WA 98004-5727 - Phone
- (425) 458-8010
- NPI assigned
- Sep 6, 2014
- Last updated
- Jul 13, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MA 60491431 | WA | Primary |
Addresses
Primary practice location
10657 NE 2ND St
Bellevue, WA 98004-5727
Mailing address
34804 SE Jacobia St
Snoqualmie, WA 98065-5019
Phone (206) 331-7675
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA 60491431 | WA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Breeze Spa LLC | Current | Accepting new patients |
Locations
10657 NE 2nd St
Bellevue, WA 98004
Phone (425) 458-8010
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626134400000",
"number": "1841691144",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34804 SE JACOBIA ST",
"city": "SNOQUALMIE",
"state": "WA",
"postal_code": "980655019",
"telephone_number": "206-331-7675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10657 NE 2ND ST",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980045727",
"telephone_number": "425-458-8010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANG",
"first_name": "LI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-09-06",
"last_updated": "2021-07-13",
"certification_date": "2021-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "MA 60491431",
"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 Jul 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.