Healthcare Provider Details

I. General information

NPI: 1023552353
Provider Name (Legal Business Name): JAY YRI-HALEN CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2016
Last Update Date: 12/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12951 NE BEL RED RD STE 120
BELLEVUE WA
98005-2628
US

IV. Provider business mailing address

12951 NE BEL RED RD STE 120
BELLEVUE WA
98005-2628
US

V. Phone/Fax

Practice location:
  • Phone: 425-497-2107
  • Fax: 425-455-2910
Mailing address:
  • Phone: 425-497-2107
  • Fax: 425-455-2910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License NumberCH0001239
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH0001239
License Number StateWA

VIII. Authorized Official

Name: DR. JAY A YRI-HALEN
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 425-497-2107