Provider Demographics
NPI:1316181332
Name:ACUPUNCTURE & CHIROPRACTIC INTEGRATIVE CLINIC
Entity Type:Organization
Organization Name:ACUPUNCTURE & CHIROPRACTIC INTEGRATIVE CLINIC
Other - Org Name:ACI CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:KE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-285-9020
Mailing Address - Street 1:1313 MARKET ST
Mailing Address - Street 2:SUITE 3000
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-5456
Mailing Address - Country:US
Mailing Address - Phone:425-285-9020
Mailing Address - Fax:425-285-9018
Practice Address - Street 1:1313 MARKET ST
Practice Address - Street 2:SUITE 3000
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-5456
Practice Address - Country:US
Practice Address - Phone:425-285-9020
Practice Address - Fax:425-285-9018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-21
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60032055111N00000X
WAAC60003843171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACH00102Medicare PIN