Provider Demographics
NPI:1083917082
Name:ACI HEALTH & WELLNESS CENTER
Entity Type:Organization
Organization Name:ACI HEALTH & WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINGYI
Authorized Official - Middle Name:
Authorized Official - Last Name:FAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-778-1188
Mailing Address - Street 1:18205 ALDERWOOD MALL PKWY
Mailing Address - Street 2:UNIT K
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-3913
Mailing Address - Country:US
Mailing Address - Phone:425-778-1188
Mailing Address - Fax:425-778-1188
Practice Address - Street 1:18205 ALDERWOOD MALL PKWY
Practice Address - Street 2:UNIT K
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98037-3913
Practice Address - Country:US
Practice Address - Phone:425-778-1188
Practice Address - Fax:425-778-1188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-13
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034792174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty