Provider Demographics
NPI:1417164682
Name:MEYLE, YOLANDA M (LMP)
Entity Type:Individual
Prefix:MRS
First Name:YOLANDA
Middle Name:M
Last Name:MEYLE
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15513 NE 85TH ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682-9484
Mailing Address - Country:US
Mailing Address - Phone:360-402-8592
Mailing Address - Fax:
Practice Address - Street 1:15513 NE 85TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98682-9484
Practice Address - Country:US
Practice Address - Phone:360-402-8592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00017773225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist