Provider Demographics
NPI:1790874139
Name:TAN, YANMIN (LAC, LMP,)
Entity Type:Individual
Prefix:
First Name:YANMIN
Middle Name:
Last Name:TAN
Suffix:
Gender:F
Credentials:LAC, LMP,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 228TH ST SE
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021-9316
Mailing Address - Country:US
Mailing Address - Phone:425-806-4861
Mailing Address - Fax:425-806-4861
Practice Address - Street 1:727 228TH ST SE
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98021-9316
Practice Address - Country:US
Practice Address - Phone:425-806-4861
Practice Address - Fax:425-806-4861
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00002000171100000X
WAMA00013299225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171100000XOther Service ProvidersAcupuncturist
Not Answered225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist