1962587824 NPI number — ACUPUNCTURE CLINIC NORTH WEST, 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 1962587824 NPI number — ACUPUNCTURE CLINIC NORTH WEST, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACUPUNCTURE CLINIC NORTH WEST, 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:
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:
1962587824
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/18/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16761 NE 79TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
REDMOND
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98052-4425
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-869-7400
Provider Business Mailing Address Fax Number:
425-869-5400

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16761 NE 79TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
REDMOND
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98052-4425
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-869-7400
Provider Business Practice Location Address Fax Number:
425-869-5400
Provider Enumeration Date:
10/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HYMEL
Authorized Official First Name:
TODD
Authorized Official Middle Name:
STEPHEN
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
206-683-8202

Provider Taxonomy Codes

  • Taxonomy code: 171100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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