Provider Demographics
NPI:1619572609
Name:LAI, YI-JU (AEMP)
Entity Type:Individual
Prefix:
First Name:YI-JU
Middle Name:
Last Name:LAI
Suffix:
Gender:F
Credentials:AEMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16404 SMOKEY POINT BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-8417
Mailing Address - Country:US
Mailing Address - Phone:360-363-4040
Mailing Address - Fax:360-363-4041
Practice Address - Street 1:16404 SMOKEY POINT BLVD STE 101
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-8417
Practice Address - Country:US
Practice Address - Phone:360-363-4040
Practice Address - Fax:360-363-4041
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC61113813171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist