Provider Demographics
NPI:1306380324
Name:JK SQUARED, LLC
Entity Type:Organization
Organization Name:JK SQUARED, LLC
Other - Org Name:DR. JANNINE KRAUSE NATUROPATHIC MEDICINE & ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NATUROPATHIC DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANNINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAUSE
Authorized Official - Suffix:
Authorized Official - Credentials:ND, EAMP
Authorized Official - Phone:253-254-1549
Mailing Address - Street 1:1010 N ANDERSON ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-6814
Mailing Address - Country:US
Mailing Address - Phone:253-254-1549
Mailing Address - Fax:
Practice Address - Street 1:1010 N ANDERSON ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-6814
Practice Address - Country:US
Practice Address - Phone:253-254-1549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-09
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60426985171100000X
WANT00001645175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty