Individual provider Active NPI

Michael E Liquori, M.D.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Tukwila, WA
National Provider Identifier
1851680045
Registry record updated Nov 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
MD60996251 Issued in WA
Practice address
2811 S 102ND St Ste 200
Tukwila, WA 98168-1816
Phone
(206) 320-4000
NPI assigned
Mar 29, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0077357 MD
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X MD454796 PA
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X MD60996251 WA Primary

Addresses

Primary practice location

2811 S 102ND St Ste 200
Tukwila, WA 98168-1816

Mailing address

2811 S 102ND St Ste 200
Tukwila, WA 98168-1816
Phone (206) 320-4000

Other practice location 1

111 S 11th St
Philadelphia, PA 19107-4824
Phone (215) 955-6180

Other identifiers 1

IdentifierTypeStateIssuer
103039001 0001MedicaidPA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0077357MDMDInternal Medicine Physician
MD454796PAMDInternal Medicine Physician
MD60996251WAMDHospice and Palliative Medicine (Internal Medicine) Physician

Interoperability endpoints

  • Direct secure messaging: mliquori1172348@wm.providencedirect.org

NPI Registry JSON

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

{
    "created_epoch": "1301356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572566400000",
    "number": "1851680045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2811 S 102ND ST STE 200",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981681816",
            "telephone_number": "206-320-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 S 102ND ST STE 200",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981681816",
            "telephone_number": "206-320-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 S 11th St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191074824",
            "country_code": "US",
            "telephone_number": "215-955-6180",
            "fax_number": "215-955-6410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIQUORI",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-29",
        "last_updated": "2019-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0077357",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD454796",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "WA",
            "license": "MD60996251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103039001 0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tukwila, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.