Provider Demographics
NPI:1649743303
Name:JANG, YUN MI (LMP)
Entity type:Individual
Prefix:
First Name:YUN MI
Middle Name:
Last Name:JANG
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11506 NE 128TH ST APT 17
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-6391
Mailing Address - Country:US
Mailing Address - Phone:206-432-2991
Mailing Address - Fax:
Practice Address - Street 1:16771 NE 80TH ST STE 208
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3959
Practice Address - Country:US
Practice Address - Phone:206-432-2991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-05
Last Update Date:2024-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60917712225700000X
WAMA60917712225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist