Healthcare Provider Details

I. General information

NPI: 1013871912
Provider Name (Legal Business Name): WENYING TAN CMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

842 N SUMMIT BLVD UNIT 28
FRISCO CO
80443-5891
US

IV. Provider business mailing address

842 N SUMMIT BLVD UNIT 28
FRISCO CO
80443-5891
US

V. Phone/Fax

Practice location:
  • Phone: 970-718-1888
  • Fax:
Mailing address:
  • Phone: 970-718-1888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number7323
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: