Provider Demographics
NPI:1104362490
Name:MH WELLNESS & ACUPUNCTURE STUDIO
Entity Type:Organization
Organization Name:MH WELLNESS & ACUPUNCTURE STUDIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:HO
Authorized Official - Middle Name:YONG
Authorized Official - Last Name:LIM
Authorized Official - Suffix:
Authorized Official - Credentials:EAMP, LAC, HERBALIST
Authorized Official - Phone:253-632-0555
Mailing Address - Street 1:7137 MONTEVISTA DR SE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98092-8224
Mailing Address - Country:US
Mailing Address - Phone:253-632-0555
Mailing Address - Fax:253-944-4074
Practice Address - Street 1:11511 CANTERWOOD BLVD NW
Practice Address - Street 2:STE 40
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-5813
Practice Address - Country:US
Practice Address - Phone:253-632-0555
Practice Address - Fax:253-944-4074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-11
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60695229171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty