Healthcare Provider Details

I. General information

NPI: 1396103651
Provider Name (Legal Business Name): JANELLE YIM N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2016
Last Update Date: 12/22/2021
Certification Date: 12/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 9TH AVE NE STE 300
SEATTLE WA
98105-4762
US

IV. Provider business mailing address

3183 WILSHIRE BLVD # 196D36
LOS ANGELES CA
90010-1211
US

V. Phone/Fax

Practice location:
  • Phone: 877-622-0229
  • Fax: 425-504-8009
Mailing address:
  • Phone: 323-977-0056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number836368
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number95003808
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number61102362
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95003808
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95003808
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: