Provider Demographics
NPI:1336678697
Name:HUANG, YONG (MASSAGE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:YONG
Middle Name:
Last Name:HUANG
Suffix:
Gender:M
Credentials:MASSAGE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12505 NE BEL RED RD STE 188
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2510
Mailing Address - Country:US
Mailing Address - Phone:425-484-9023
Mailing Address - Fax:206-309-9063
Practice Address - Street 1:12505 BEL-RED ROAD
Practice Address - Street 2:SUITE 188
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005
Practice Address - Country:US
Practice Address - Phone:425-484-9023
Practice Address - Fax:206-309-9063
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60655888225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMA60655888OtherWASHINGTON STATE DEPARTMENT OF HEALTH