Provider Demographics
NPI:1629300777
Name:GARCIA GARCIA, YVONNE HAZEL (LMP)
Entity Type:Individual
Prefix:MRS
First Name:YVONNE
Middle Name:HAZEL
Last Name:GARCIA GARCIA
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:MISS
Other - First Name:YVONNE
Other - Middle Name:HAZEL
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6300 9TH AVE NE STE 106
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-8516
Mailing Address - Country:US
Mailing Address - Phone:206-718-1455
Mailing Address - Fax:206-524-5054
Practice Address - Street 1:6300 9TH AVE NE STE 106
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-8516
Practice Address - Country:US
Practice Address - Phone:206-718-1455
Practice Address - Fax:206-524-5054
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-31
Last Update Date:2010-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60106768225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist