Provider Demographics
NPI:1700485919
Name:YAKAM AZAH, YANIQUE RICIE NANA (ARNP)
Entity Type:Individual
Prefix:
First Name:YANIQUE RICIE
Middle Name:NANA
Last Name:YAKAM AZAH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MRS
Other - First Name:YANIQUE RICIE
Other - Middle Name:N/A
Other - Last Name:NANA YAKAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:6811 S 204TH ST STE 280
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-1352
Mailing Address - Country:US
Mailing Address - Phone:888-674-5871
Mailing Address - Fax:206-694-2291
Practice Address - Street 1:6811 S 204TH ST STE 280
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-1352
Practice Address - Country:US
Practice Address - Phone:888-674-5871
Practice Address - Fax:206-694-2291
Is Sole Proprietor?:No
Enumeration Date:2020-10-19
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61097737363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily