Provider Demographics
NPI:1003960162
Name:STIRITZ, ROBIN DIANNE (LAC)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:DIANNE
Last Name:STIRITZ
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:222 KENYON ST NW
Mailing Address - Street 2:SUITE 4
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-4553
Mailing Address - Country:US
Mailing Address - Phone:360-352-1868
Mailing Address - Fax:360-352-0750
Practice Address - Street 1:222 KENYON ST NW
Practice Address - Street 2:SUITE 4
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-4553
Practice Address - Country:US
Practice Address - Phone:360-352-1868
Practice Address - Fax:360-352-0750
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00000125171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist