Yong Sun Bolton, MASSAGE THERAPIST
Individual provider Active NPI Massage Therapist · Anchorage, AK
NPI 1649539347 · NPPES record last updated Oct 27, 2023
Key facts
- NPI
- 1649539347
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 101896 (AK)
- Practice address
- 4050 Lake Otis Pkwy Ste 201B
Anchorage, AK 99508-5223 - Phone
- (907) 202-3589
- Fax
- (907) 334-1015
- NPI assigned
- May 15, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101896 | AK | MD | Massage Therapist |
| MAT:12513 | HI | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MAT:12513 | HI | |
| Massage Therapist | 225700000X | 101896 | AK | Yes |
Addresses
Primary practice location
4050 Lake Otis Pkwy Ste 201B
Anchorage, AK 99508-5223
Mailing address
11620 Brook Hill CT
Anchorage, AK 99516-1969
Phone (907) 202-3589
Other names
- Yong Sun Ro
Other providers in Anchorage, AK
- Cynthia Bolivar
- Irene Boll
- Steven Bolling
- Bryan Buo Bolo
- Patrick Kevin Bolte
- Sue Boma
- Martin David Bomalaski
- Susan Bomalaski
- Jeanne R Bonar
- Kyle Andrew Bonar
All providers in Anchorage, AK · Massage Therapist in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.