Healthcare Provider Details

I. General information

NPI: 1285587667
Provider Name (Legal Business Name): YURI-GRACE BRIDGES OHASHI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2026
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 FRUIT ST
BOSTON MA
02114-2696
US

IV. Provider business mailing address

111 QUEENSBERRY ST APT 1
BOSTON MA
02215-4705
US

V. Phone/Fax

Practice location:
  • Phone: 617-643-4699
  • Fax:
Mailing address:
  • Phone: 770-557-5411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: