Provider Demographics
NPI:1568074649
Name:YU, SHIQI
Entity Type:Individual
Prefix:
First Name:SHIQI
Middle Name:
Last Name:YU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:YU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CBTCB61095815
Mailing Address - Street 1:8034 BEACON AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-4322
Mailing Address - Country:US
Mailing Address - Phone:206-280-2390
Mailing Address - Fax:
Practice Address - Street 1:8034 BEACON AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-4322
Practice Address - Country:US
Practice Address - Phone:206-280-2390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-19
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACBT.CB.61095815106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician