Healthcare Provider Details

I. General information

NPI: 1558618793
Provider Name (Legal Business Name): YUI KIN YIP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2012
Last Update Date: 08/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 LIND AVE SW
RENTON WA
98057-3323
US

IV. Provider business mailing address

872 JERICHO PL NE
RENTON WA
98059-4472
US

V. Phone/Fax

Practice location:
  • Phone: 206-687-4451
  • Fax:
Mailing address:
  • Phone: 206-849-4994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH60159164
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: