Healthcare Provider Details

I. General information

NPI: 1922464999
Provider Name (Legal Business Name): JOEL YEA L.AC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2016
Last Update Date: 01/17/2025
Certification Date: 01/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33431 13TH PL S
FEDERAL WAY WA
98003-6357
US

IV. Provider business mailing address

955 POWELL AVE SW
RENTON WA
98057-2908
US

V. Phone/Fax

Practice location:
  • Phone: 253-874-7634
  • Fax:
Mailing address:
  • Phone: 425-277-1311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC60623957
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: