Organization
WA MC SPROUT 1 LLC
Active
Other names
Elemy, Sprout Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
YURY YAKUBCHYK SR. (OWNER)
(206) 278-4342
Entity
Organization
Contact information
Practice address
100 S KING ST STE 100-1023, SEATTLE, WA 98104-3844
(206) 278-4342
(929) 384-7193
Mailing address
100 S KING ST STE 100-1023, SEATTLE, WA 98104-3844
(206) 278-4342
(929) 384-7193
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
04/14/2020
Last updated
09/27/2021
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