Provider Demographics
NPI:1043642309
Name:XIE, YI (PT)
Entity type:Individual
Prefix:
First Name:YI
Middle Name:
Last Name:XIE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9230 NE 173RD PL
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-3606
Mailing Address - Country:US
Mailing Address - Phone:661-204-1446
Mailing Address - Fax:
Practice Address - Street 1:7015 MORGAN RD
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-5029
Practice Address - Country:US
Practice Address - Phone:425-342-4790
Practice Address - Fax:425-342-4845
Is Sole Proprietor?:No
Enumeration Date:2013-08-08
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT 60361556225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist