Provider Demographics
NPI:1194007278
Name:LIN, SOFINA Y (EAMP)
Entity Type:Individual
Prefix:
First Name:SOFINA
Middle Name:Y
Last Name:LIN
Suffix:
Gender:F
Credentials:EAMP
Other - Prefix:
Other - First Name:SOFINA
Other - Middle Name:
Other - Last Name:LIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1403 NE 86TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-3165
Mailing Address - Country:US
Mailing Address - Phone:206-963-7764
Mailing Address - Fax:
Practice Address - Street 1:3417 EVANSTON AVE N STE 223
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8686
Practice Address - Country:US
Practice Address - Phone:503-741-9066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-14
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60238271171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist