Provider Demographics
NPI:1154442275
Name:LAGGNER, ALFRED (LAC, PHD)
Entity Type:Individual
Prefix:
First Name:ALFRED
Middle Name:
Last Name:LAGGNER
Suffix:
Gender:M
Credentials:LAC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1028 NE 187TH ST
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98155-2219
Mailing Address - Country:US
Mailing Address - Phone:206-428-7873
Mailing Address - Fax:
Practice Address - Street 1:6527 21ST AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-6947
Practice Address - Country:US
Practice Address - Phone:206-428-7873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00002980171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAC00002980OtherACUPUNCTURE LICENCE