Provider Demographics
NPI:1376187971
Name:HEALING LIFE ACUPUNCTURE, PLLC
Entity Type:Organization
Organization Name:HEALING LIFE ACUPUNCTURE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWENER
Authorized Official - Prefix:
Authorized Official - First Name:AKIKO
Authorized Official - Middle Name:
Authorized Official - Last Name:MARUYAMA
Authorized Official - Suffix:
Authorized Official - Credentials:ACUPUNCTURIST
Authorized Official - Phone:206-399-8581
Mailing Address - Street 1:2025 112TH AVE NE STE 301
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-2950
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2025 112TH AVE NE STE 301
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-2950
Practice Address - Country:US
Practice Address - Phone:206-399-8581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-06
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty