Healthcare Provider Details

I. General information

NPI: 1508371667
Provider Name (Legal Business Name): BO-RIN PARK YOON LMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2017
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9900 WILLOWS RD NE
REDMOND WA
98052-2531
US

IV. Provider business mailing address

1928 205TH PL NE
SAMMAMISH WA
98074-4478
US

V. Phone/Fax

Practice location:
  • Phone: 206-679-4284
  • Fax:
Mailing address:
  • Phone: 206-679-4284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC61586550
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberCB60810756
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: