Provider Demographics
NPI:1104990142
Name:GOSHERT, YIN-YIN NG (DPT)
Entity type:Individual
Prefix:
First Name:YIN-YIN
Middle Name:NG
Last Name:GOSHERT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:YIN-YIN
Other - Middle Name:
Other - Last Name:NG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:302-962-2223
Mailing Address - Fax:
Practice Address - Street 1:4220 HOYT AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-2317
Practice Address - Country:US
Practice Address - Phone:425-258-5330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60083635225100000X
NY027375225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ26C91Medicare ID - Type UnspecifiedMEDICARE PROVIDER