Provider Demographics
NPI:1073386371
Name:YOLO MASSAGE CLINIC
Entity Type:Organization
Organization Name:YOLO MASSAGE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:YING
Authorized Official - Middle Name:
Authorized Official - Last Name:NIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-356-5625
Mailing Address - Street 1:13723 100TH AVE NE STE A
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-5247
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13723 100TH AVE NE STE A
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-5247
Practice Address - Country:US
Practice Address - Phone:425-636-8923
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain