Provider Demographics
NPI:1225244825
Name:ELLIOTT, DARCY DUANE (LAC)
Entity Type:Individual
Prefix:MR
First Name:DARCY
Middle Name:DUANE
Last Name:ELLIOTT
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 1:1155 N STATE ST STE 610
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-5024
Mailing Address - Country:US
Mailing Address - Phone:360-647-0228
Mailing Address - Fax:360-671-5218
Practice Address - Street 1:1155 N STATE ST STE 610
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-5024
Practice Address - Country:US
Practice Address - Phone:360-647-0228
Practice Address - Fax:360-671-5218
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA029501AC00000169171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist