Provider Demographics
NPI:1063110997
Name:ASARE-KONADU, YACOBA (LMT)
Entity type:Individual
Prefix:MS
First Name:YACOBA
Middle Name:
Last Name:ASARE-KONADU
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15100 6TH AVE SW UNIT 723
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-1956
Mailing Address - Country:US
Mailing Address - Phone:206-909-2624
Mailing Address - Fax:
Practice Address - Street 1:600 N 36TH ST STE 317
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8698
Practice Address - Country:US
Practice Address - Phone:253-642-7618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60833316225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist