Provider Demographics
NPI:1093780694
Name:WELLNESS LIFE ACUPUNCTURE
Entity Type:Organization
Organization Name:WELLNESS LIFE ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHD. DOM
Authorized Official - Prefix:DR
Authorized Official - First Name:SHENG
Authorized Official - Middle Name:
Authorized Official - Last Name:GE
Authorized Official - Suffix:
Authorized Official - Credentials:LAC DOM
Authorized Official - Phone:206-858-3013
Mailing Address - Street 1:14124 PHINNEY AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-6847
Mailing Address - Country:US
Mailing Address - Phone:206-858-3013
Mailing Address - Fax:
Practice Address - Street 1:901 BOREN AVE STE 1700
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3549
Practice Address - Country:US
Practice Address - Phone:206-858-3013
Practice Address - Fax:206-858-3013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-17
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC 60187678171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty