Provider Demographics
NPI:1053075184
Name:ANCIENT HEALING ARTS, PLLC
Entity Type:Organization
Organization Name:ANCIENT HEALING ARTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:425-381-9561
Mailing Address - Street 1:3601 FREMONT AVE N STE 209
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-8753
Mailing Address - Country:US
Mailing Address - Phone:425-318-9561
Mailing Address - Fax:206-299-4800
Practice Address - Street 1:3601 FREMONT AVE N STE 209
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8753
Practice Address - Country:US
Practice Address - Phone:425-318-9561
Practice Address - Fax:206-299-4800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center