Provider Demographics
NPI:1710655857
Name:YI, CAROLYN NALAE
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:NALAE
Last Name:YI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4910 MASSACHUSETTS AVE NW STE 308
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-4382
Mailing Address - Country:US
Mailing Address - Phone:202-695-1000
Mailing Address - Fax:
Practice Address - Street 1:4910 MASSACHUSETTS AVE NW STE 308
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-4382
Practice Address - Country:US
Practice Address - Phone:202-695-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-02
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical