Provider Demographics
NPI:1235485814
Name:ROTHSTEIN, JOSEPH (LAC, DIPLOM)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:ROTHSTEIN
Suffix:
Gender:M
Credentials:LAC, DIPLOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1519 9TH ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-4600
Mailing Address - Country:US
Mailing Address - Phone:360-653-2526
Mailing Address - Fax:360-363-6699
Practice Address - Street 1:1519 9TH ST
Practice Address - Street 2:SUITE 103
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-4600
Practice Address - Country:US
Practice Address - Phone:360-653-2526
Practice Address - Fax:360-363-6699
Is Sole Proprietor?:No
Enumeration Date:2012-08-01
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0910077315171100000X
WAAC 60343617171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist