Provider Demographics
NPI:1316550049
Name:YAMLIKHA, SADEDDIN (DC)
Entity Type:Individual
Prefix:
First Name:SADEDDIN
Middle Name:
Last Name:YAMLIKHA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8202 NE STATE HIGHWAY 104 STE 105
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:WA
Mailing Address - Zip Code:98346-9454
Mailing Address - Country:US
Mailing Address - Phone:360-297-0037
Mailing Address - Fax:
Practice Address - Street 1:8202 NE STATE HIGHWAY 104 STE 105
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:WA
Practice Address - Zip Code:98346-9454
Practice Address - Country:US
Practice Address - Phone:360-297-0037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH61093887111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor