Provider Demographics
NPI:1497243810
Name:GAO, YING (CMT, MPL)
Entity Type:Individual
Prefix:
First Name:YING
Middle Name:
Last Name:GAO
Suffix:
Gender:F
Credentials:CMT, MPL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 1ST ST NE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-5052
Mailing Address - Country:US
Mailing Address - Phone:253-833-8218
Mailing Address - Fax:
Practice Address - Street 1:226 1ST ST NE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-5052
Practice Address - Country:US
Practice Address - Phone:253-833-8218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-01
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60170329225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty