1114065273 NPI number — JING CHENG INSTITUTE OF TRADITIONAL CHINESE MEDICINE INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114065273 NPI number — JING CHENG INSTITUTE OF TRADITIONAL CHINESE MEDICINE INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JING CHENG INSTITUTE OF TRADITIONAL CHINESE MEDICINE INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114065273
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3897
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SILVERDALE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98383-3897
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-692-7000
Provider Business Mailing Address Fax Number:
360-698-4699

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9301 LINDER WAY NW
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
SILVERDALE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98383-8396
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-692-7000
Provider Business Practice Location Address Fax Number:
360-698-4699
Provider Enumeration Date:
02/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ZHANG
Authorized Official First Name:
TING
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
360-692-7000

Provider Taxonomy Codes

  • Taxonomy code: 171100000X , with the licence number:  AC00000797 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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