Provider Demographics
NPI:1124189147
Name:ESKELSON, JOHN (LAC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:ESKELSON
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1279
Mailing Address - Street 2:
Mailing Address - City:OMAK
Mailing Address - State:WA
Mailing Address - Zip Code:98841-1279
Mailing Address - Country:US
Mailing Address - Phone:509-826-0374
Mailing Address - Fax:509-826-7530
Practice Address - Street 1:25 SOUTH ASH STREET
Practice Address - Street 2:
Practice Address - City:OMAK
Practice Address - State:WA
Practice Address - Zip Code:98841
Practice Address - Country:US
Practice Address - Phone:509-826-0374
Practice Address - Fax:509-826-7530
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00000086171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist