Healthcare Provider Details

I. General information

NPI: 1831285493
Provider Name (Legal Business Name): VIRGINIA YIP M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 03/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15418 MAIN ST SUITE 200
MILL CREEK WA
98012-9030
US

IV. Provider business mailing address

PO BOX 5127
EVERETT WA
98206-5127
US

V. Phone/Fax

Practice location:
  • Phone: 425-225-8000
  • Fax:
Mailing address:
  • Phone: 425-225-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036-096933
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: