Provider Demographics
NPI:1093062507
Name:YU, MICHAEL C (MS LMHC CMHS EMMHS)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:C
Last Name:YU
Suffix:
Gender:M
Credentials:MS LMHC CMHS EMMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16503 SE 171ST PL
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98058-9589
Mailing Address - Country:US
Mailing Address - Phone:425-390-2222
Mailing Address - Fax:
Practice Address - Street 1:1160 140TH AVE NE, STE E & F
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005
Practice Address - Country:US
Practice Address - Phone:425-283-1313
Practice Address - Fax:425-283-1316
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-14
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60242118101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health