Provider Demographics
NPI:1518412576
Name:HONGYAN LLC
Entity Type:Organization
Organization Name:HONGYAN LLC
Other - Org Name:AURORA MASSAGE SPA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BOHAO
Authorized Official - Middle Name:
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-953-7000
Mailing Address - Street 1:3841 AURORA AVE N
Mailing Address - Street 2:STE 100
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-2719
Mailing Address - Country:US
Mailing Address - Phone:425-953-7000
Mailing Address - Fax:206-299-4452
Practice Address - Street 1:3841 AURORA AVE N
Practice Address - Street 2:STE 100
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-2719
Practice Address - Country:US
Practice Address - Phone:425-953-7000
Practice Address - Fax:206-299-4452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-19
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60298317225700000X
WAMA6059871225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty