Individual
YAZMIN MARISSA TANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13010 NE 20TH ST, BELLEVUE, WA 98005-2034
(425) 644-6328
Mailing address
23315 76TH AVE W, EDMONDS, WA 98026-8707
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
WA
Enumeration date
10/02/2017
Last updated
04/29/2021
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