Provider Demographics
NPI:1275143885
Name:LIN, JIAYU (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:JIAYU
Middle Name:
Last Name:LIN
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 150TH AVE SE APT 19
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-6855
Mailing Address - Country:US
Mailing Address - Phone:405-595-7283
Mailing Address - Fax:
Practice Address - Street 1:1502 LAKE TAPPS PKWY SE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98092-8227
Practice Address - Country:US
Practice Address - Phone:253-390-0019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-07
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61046741183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist