Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 18234 | OR |
NPI | 1013288372 |
---|---|
Provider Name | Hee Joon Yang |
First Address | Eugene, OR 97401-5005 |
Second Address | Eugene, OR 97401-4982 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2012 |
Last Update Date | 19/01/2012 |