Provider Demographics
NPI:1679766828
Name:YANG, YUNFAN (ND, LAC, LMP)
Entity type:Individual
Prefix:
First Name:YUNFAN
Middle Name:
Last Name:YANG
Suffix:
Gender:M
Credentials:ND, LAC, LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 228TH ST SE
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021-9317
Mailing Address - Country:US
Mailing Address - Phone:425-806-4861
Mailing Address - Fax:425-806-4861
Practice Address - Street 1:727 228TH ST SE
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98021-9316
Practice Address - Country:US
Practice Address - Phone:425-806-4861
Practice Address - Fax:425-806-4861
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-21
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT 60524196175F00000X
WAMA00023117225700000X
WAAC 60740047171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No171100000XOther Service ProvidersAcupuncturist