Provider Demographics
NPI:1194840009
Name:HOUSEWORTH, DEBORAH ROSE (LAC)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:ROSE
Last Name:HOUSEWORTH
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6826 28TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-7145
Mailing Address - Country:US
Mailing Address - Phone:206-525-0750
Mailing Address - Fax:206-524-6530
Practice Address - Street 1:2324 EASTLAKE AVE E STE 100
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-6532
Practice Address - Country:US
Practice Address - Phone:206-525-0750
Practice Address - Fax:206-524-6530
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2011-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00000208171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist