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General NPI Number Information
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NPI Number | 1497161541
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Entity Type | Individual
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Provider Name | ANDREA ELIZABETH YALEY DMD
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Gender | Female
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Dates
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Enumeration Date | 07/09/2014
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Last Update Date | 12/01/2021
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Provider Practice Location Address
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Address Line | 825 OAK GROVE AVE # 401
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City | MENLO PARK
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State | CA
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Zip | 94025-4434
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Country | US
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Telephone | 650-325-8030
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Fax |
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Provider Business Mailing Address
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Address Line | 21121 50TH DR SE
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City | BOTHELL
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State | WA
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Zip | 98021-7981
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 63551
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License Number State | CA
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