Provider Demographics
NPI:1679880033
Name:YEN WELLNESS LLC
Entity Type:Organization
Organization Name:YEN WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ELISSA
Authorized Official - Last Name:FRASER SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:541-915-2257
Mailing Address - Street 1:655 E 11TH AVE
Mailing Address - Street 2:SUITE 9
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3621
Mailing Address - Country:US
Mailing Address - Phone:541-870-7692
Mailing Address - Fax:
Practice Address - Street 1:655 E 11TH AVE
Practice Address - Street 2:SUITE 9
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3621
Practice Address - Country:US
Practice Address - Phone:541-915-2257
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-08
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty