1316181332 NPI number — ACUPUNCTURE & CHIROPRACTIC INTEGRATIVE CLINIC

Table of content: (NPI 1316181332)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316181332 NPI number — ACUPUNCTURE & CHIROPRACTIC INTEGRATIVE CLINIC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACUPUNCTURE & CHIROPRACTIC INTEGRATIVE CLINIC
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:
ACI CLINIC
Provider Other Organization Name Type Code:
5
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:
1316181332
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/15/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1313 MARKET ST
Provider Second Line Business Mailing Address:
SUITE 3000
Provider Business Mailing Address City Name:
KIRKLAND
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98033-5456
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-285-9020
Provider Business Mailing Address Fax Number:
425-285-9018

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1313 MARKET ST
Provider Second Line Business Practice Location Address:
SUITE 3000
Provider Business Practice Location Address City Name:
KIRKLAND
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98033-5456
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-285-9020
Provider Business Practice Location Address Fax Number:
425-285-9018
Provider Enumeration Date:
04/21/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ZANG
Authorized Official First Name:
KE
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
425-285-9020

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  CH60032055 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 171100000X , with the licence number: AC60003843 , 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)