Provider Demographics
NPI:1164259404
Name:ROBERTSON, YULIYA (RDH)
Entity type:Individual
Prefix:
First Name:YULIYA
Middle Name:
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10420 9TH DR SE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-4716
Mailing Address - Country:US
Mailing Address - Phone:425-737-7539
Mailing Address - Fax:
Practice Address - Street 1:209 DAYTON ST STE 101
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98020-3581
Practice Address - Country:US
Practice Address - Phone:425-775-7325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADH60674508124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist