Provider Demographics
NPI:1710400346
Name:YEN FAMILY WELLNESS, LLC
Entity Type:Organization
Organization Name:YEN FAMILY WELLNESS, LLC
Other - Org Name:LAURA YEN, LICSW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:ALISA
Authorized Official - Last Name:YEN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LICSW
Authorized Official - Phone:425-870-7192
Mailing Address - Street 1:826 102ND AVE NE STE 300
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-4158
Mailing Address - Country:US
Mailing Address - Phone:425-870-7192
Mailing Address - Fax:
Practice Address - Street 1:826 102ND AVE NE STE 300
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-4158
Practice Address - Country:US
Practice Address - Phone:425-870-7192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW00004429261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health