1508021262 NPI number — MRS. YVETTE MELINDA SYLVANDER NOVAK LMP

Table of content: MRS. YVETTE MELINDA SYLVANDER NOVAK LMP (NPI 1508021262)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508021262 NPI number — MRS. YVETTE MELINDA SYLVANDER NOVAK LMP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SYLVANDER NOVAK
Provider First Name:
YVETTE
Provider Middle Name:
MELINDA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LMP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1508021262
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/22/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2028 S 272ND ST
Provider Second Line Business Mailing Address:
YVETTES MASSAGE THERAPY
Provider Business Mailing Address City Name:
KENT
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98032
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2028 S 272ND ST
Provider Second Line Business Practice Location Address:
YVETTES MASSAGE THERAPY
Provider Business Practice Location Address City Name:
KENT
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98032
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-839-4210
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/22/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 261QH0100X , with the licence number:  MA00007886 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com