Provider Demographics
NPI:1730417460
Name:YEGIYAN, ZHANNA (LMP)
Entity type:Individual
Prefix:
First Name:ZHANNA
Middle Name:
Last Name:YEGIYAN
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 140TH AVE NE STE 202
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-3400
Mailing Address - Country:US
Mailing Address - Phone:425-462-6604
Mailing Address - Fax:425-562-3292
Practice Address - Street 1:875 140 AVE NE 202
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-3400
Practice Address - Country:US
Practice Address - Phone:425-462-6604
Practice Address - Fax:425-562-3292
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-18
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00009007225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist