Provider Demographics
NPI:1619178027
Name:LIANG, DAVID BENJAMIN (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BENJAMIN
Last Name:LIANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10921 115TH CT NE APT C201
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-3823
Mailing Address - Country:US
Mailing Address - Phone:202-271-4503
Mailing Address - Fax:
Practice Address - Street 1:21600 HIGHWAY 99 STE 260
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-8049
Practice Address - Country:US
Practice Address - Phone:425-774-2650
Practice Address - Fax:425-774-2643
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV14761207RG0100X
WAMD60197486207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2048950Medicaid