MEDICARE: DR. JAY A. YRI-HALEN D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH00001239	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	910990339	OTHER	WA	TAX ID #
2	0015379	OTHER	WA	L&I PROVIDER #
3	600222041	OTHER	WA	UBI #
4	CH00001239	OTHER	WA	WA STATE LICENSE #
5	0181959	OTHER	WA	L&I IME PROVIDER #

General Provider Information

NPI Number	:	1396815742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAY A. YRI-HALEN D.C.

Provider Business Mailing Address
First Line	:	12951 NE BEL RED RD STE 120
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98005-2628
Country	:	US
Telephone Number	:	425-497-2107
Fax Number	:	425-455-2910

Provider Business Practice Location Address
First Line	:	12951 NE BEL RED RD STE 120
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98005-2628
Country	:	US
Telephone Number	:	425-497-2107
Fax Number	:	425-455-2910

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	11/21/2016

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Practice Fax: 425-455-2910

Directions to “ DR. JAY A. YRI-HALEN D.C.” Practice Location

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