1366787905 NPI number — MS. BARBARA H KRAXBERGER LIC. ACU DIPL OF ACU

Table of content: MS. BARBARA H KRAXBERGER LIC. ACU DIPL OF ACU (NPI 1366787905)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366787905 NPI number — MS. BARBARA H KRAXBERGER LIC. ACU DIPL OF ACU

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KRAXBERGER
Provider First Name:
BARBARA
Provider Middle Name:
H
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LIC. ACU DIPL OF ACU
Provider Gender Code:
F

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:
1366787905
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/11/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
367 OLYMPIC VIEW AVE NE # 1613
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OCEAN SHORES
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98569-9552
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-998-6317
Provider Business Mailing Address Fax Number:
360-940-7194

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
548 POINT BROWN AVE NE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OCEAN SHORES
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98569
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-998-6317
Provider Business Practice Location Address Fax Number:
509-413-1217
Provider Enumeration Date:
12/08/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171100000X , with the licence number:  AC60105963 , 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)

  • Identifier: AC60105963 . This is a "ACUPUNCTURIST" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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