Provider Demographics
NPI:1467515999
Name:YI, JOHN J (DC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:YI
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 1:15118 MAIN ST
Mailing Address - Street 2:#500
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-1653
Mailing Address - Country:US
Mailing Address - Phone:425-337-1200
Mailing Address - Fax:
Practice Address - Street 1:15118 MAIN ST
Practice Address - Street 2:#500
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-1653
Practice Address - Country:US
Practice Address - Phone:425-337-1200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00003509111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor