Healthcare Provider Details

I. General information

NPI: 1285840165
Provider Name (Legal Business Name): SHAPING YIN LMP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 01/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2208 NW MARKET ST # 408
SEATTLE WA
98107-4030
US

IV. Provider business mailing address

13717 GREENWOOD AVE N APT C
SEATTLE WA
98133-6875
US

V. Phone/Fax

Practice location:
  • Phone: 206-876-0138
  • Fax:
Mailing address:
  • Phone: 206-876-0138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number00022834
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: