Provider Demographics
NPI:1265834626
Name:MAPLE VALLEY ACUPUNCTURE
Entity Type:Organization
Organization Name:MAPLE VALLEY ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:STEGER
Authorized Official - Suffix:
Authorized Official - Credentials:EAMP, LAC
Authorized Official - Phone:425-275-8459
Mailing Address - Street 1:22142 SE 237TH ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:MAPLE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98038-8534
Mailing Address - Country:US
Mailing Address - Phone:425-275-8459
Mailing Address - Fax:
Practice Address - Street 1:22142 SE 237TH ST
Practice Address - Street 2:SUITE 3
Practice Address - City:MAPLE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:98038-8534
Practice Address - Country:US
Practice Address - Phone:425-275-8459
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60503211171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty