XINSHENG MICHAEL LIAO, MD PHD - NPI NUMBER 1619963543

Summary

Provider Name: XINSHENG MICHAEL LIAO, MD PHD

NPI Number: 1619963543

Clasification: Internal Medicine (207RH0003X)

Specialization: Hematology & Oncology

Organization: PARTNER ONCOLOGY INC

Address:
1519 3RD ST SE STE 260
PUYALLUP, WA
ZIP 98372

Phone Number: (253) 770-1700



Detailed Information

Xinsheng Michael Liao, MD PHD is a hematology & oncology internist in Puyallup, WA with 32 years of experience. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. The assigned NPI number for this provider is 1619963543 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business address is:

1519 3RD ST SE STE 260
PUYALLUP, WA
ZIP 98372-716
Phone: (253) 770-1700
Fax: (253) 770-1702

The enumeration date for this NPI number is 9/26/2005 and was last updated on 8/5/2008.

Map - Location of Practice

Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 207RH0003X Internal Medicine Hematology & Oncology MD00036160 WA Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 8800934 MEDICARE ID-TYPE UNSPECIFIED
2 8254450 MEDICAID WA
3 H15029 MEDICARE UPIN

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1619963543 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 1 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Provider Last Name Legal Name LIAO The last name of the provider. If the provider is an individual, this is the legal name.
4 Provider First Name XINSHENG The first name of the provider, if the provider is an individual.
5 Provider Middle Name MICHAEL The middle name of the provider, if the provider is an individual.
6 Provider Credential Text MD PHD The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
7 Provider First Line Business Practice Location Address 1519 3RD ST SE STE 260 The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
8 Provider Business Practice Location Address City Name PUYALLUP The city name in the location address of the provider being identified.
9 Provider Business Practice Location Address State Name WA The State code in the location of the provider being identified.
10 Provider Business Practice Location Address Postal Code 983723716 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
11 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
12 Provider Business Practice Location Address Telephone Number 2537701700 The telephone number associated with the location address of the provider being identified.
13 Provider Business Practice Location Address Fax Number 2537701702 The fax number associated with the location address of the provider being identified.
14 Provider Enumeration Date 9/26/2005 The date the provider was assigned a unique identifier (assigned an NPI).
15 Last Update Date 8/5/2008 The date that a record was last updated or changed.
16 Provider Gender Code M The code designating the provider’s gender if the provider is a person.
17 Healthcare Provider Taxonomy Code 1 207RH0003X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
18 Provider License Number 1 MD00036160 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
19 Provider License Number State Code 1 WA The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
20 Healthcare Provider Primary Taxonomy Switch 1 Y
21 Other Provider Identifier 1 8800934 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
22 Other Provider Identifier Type Code 1 04 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
23 Other Provider Identifier 2 8254450 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
24 Other Provider Identifier Type Code 2 05 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
25 Other Provider Identifier State 2 WA
26 Other Provider Identifier 3 H15029 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
27 Other Provider Identifier Type Code 3 02 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
28 Is Sole Proprietor Y Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No

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This page was last updated on: 4/19/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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