Healthcare Provider Details
I. General information
NPI: 1386330645
Provider Name (Legal Business Name): YUYIN RUAN BCBA, M.ED, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/11/2023
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7808 PACIFIC AVE STE 9
TACOMA WA
98408-7039
US
IV. Provider business mailing address
1085 103RD AVE NE APT 307
BELLEVUE WA
98004-4064
US
V. Phone/Fax
- Phone: 509-321-7590
- Fax:
- Phone: 425-247-4668
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | 1-24-76205 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: