Provider Demographics
NPI:1033662853
Name:YU, YIN (PT)
Entity type:Individual
Prefix:
First Name:YIN
Middle Name:
Last Name:YU
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 S 31ST ST
Mailing Address - Street 2:APT 107
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105-1445
Mailing Address - Country:US
Mailing Address - Phone:503-313-5928
Mailing Address - Fax:
Practice Address - Street 1:1702 HARLAN DR
Practice Address - Street 2:SUITE A
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-3667
Practice Address - Country:US
Practice Address - Phone:402-682-4800
Practice Address - Fax:402-280-5692
Is Sole Proprietor?:No
Enumeration Date:2016-07-28
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR61640225100000X
NE3575225100000X
IA083314225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist