Healthcare Provider Details
I. General information
NPI: 1861189078
Provider Name (Legal Business Name): YEON JI ISABELLE CHOI
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/18/2023
Last Update Date: 06/19/2024
Certification Date: 06/19/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
999 164TH AVE NE
BELLEVUE WA
98008-3518
US
IV. Provider business mailing address
11750 SE 62ND ST
BELLEVUE WA
98006-6350
US
V. Phone/Fax
- Phone: 425-747-4937
- Fax:
- Phone: 425-463-9761
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | CBT.CB.61372600 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: