Healthcare Provider Details

I. General information

NPI: 1912888611
Provider Name (Legal Business Name): LOIS AHREUM YANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AHREUM KIM

II. Dates (important events)

Enumeration Date: 09/09/2025
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4030 LAKE WASHINGTON BLVD NE STE 201
KIRKLAND WA
98033-7870
US

IV. Provider business mailing address

4030 LAKE WASHINGTON BLVD NE STE 201
KIRKLAND WA
98033-7870
US

V. Phone/Fax

Practice location:
  • Phone: 206-414-8918
  • Fax: 206-260-4280
Mailing address:
  • Phone: 206-414-8918
  • Fax: 206-260-4280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: