Provider Demographics
NPI:1083827927
Name:JIN, WENZHEN (PHD, LAC)
Entity Type:Individual
Prefix:DR
First Name:WENZHEN
Middle Name:
Last Name:JIN
Suffix:
Gender:F
Credentials:PHD, LAC
Other - Prefix:DR
Other - First Name:LORI
Other - Middle Name:
Other - Last Name:JIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD, LAC
Mailing Address - Street 1:12919 NE 147TH PL
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-4634
Mailing Address - Country:US
Mailing Address - Phone:206-979-3149
Mailing Address - Fax:425-820-2942
Practice Address - Street 1:13118 121ST WAY NE
Practice Address - Street 2:SUITE 100
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-3004
Practice Address - Country:US
Practice Address - Phone:206-979-3149
Practice Address - Fax:425-820-2942
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00000429171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist