1659017689 NPI number — WHITE SALMON ACUPUNCTURE LLP

Table of content: (NPI 1659017689)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659017689 NPI number — WHITE SALMON ACUPUNCTURE LLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WHITE SALMON ACUPUNCTURE LLP
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:
1659017689
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/28/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 179
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUSUM
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98623-0179
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
418 NE TOHOMISH ST.
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
WHITE SALMON
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98672
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-536-0535
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/11/2022

Additional Information

Authorized Official

Authorized Official Last Name:
WHITRIDGE
Authorized Official First Name:
SERENA
Authorized Official Middle Name:
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
360-524-2788

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)

  • Identifier: 1114598141 . This is a "NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1659017689 . This is a "NPI TYPE 2" identifier . This identifiers is of the category "OTHER".
  • Identifier: AC61132900 . This is a "ACUPUNCTURE STATE LICENSE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 1083215388 . This is a "NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: AC61153026 . This is a "ACUPUNCTURE STATE LICENSE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com