Healthcare Provider Details

I. General information

NPI: 1770487571
Provider Name (Legal Business Name): YOLENA Y PHAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 8TH AVE S
SEATTLE WA
98104-3006
US

IV. Provider business mailing address

720 8TH AVE S
SEATTLE WA
98104-3006
US

V. Phone/Fax

Practice location:
  • Phone: 206-788-3700
  • Fax: 206-788-3706
Mailing address:
  • Phone: 206-788-3700
  • Fax: 206-788-3706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.60954326
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: