Provider Demographics
NPI:1407515075
Name:LITTLE SI ACUPUNCTURE & EAST ASIAN MEDICINE CLINIC, LLC
Entity Type:Organization
Organization Name:LITTLE SI ACUPUNCTURE & EAST ASIAN MEDICINE CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ACUPUNCTURIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:YU
Authorized Official - Suffix:
Authorized Official - Credentials:DAOM, LAC
Authorized Official - Phone:260-552-9756
Mailing Address - Street 1:16175 CLEVELAND ST APT 302
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-5415
Mailing Address - Country:US
Mailing Address - Phone:425-301-7466
Mailing Address - Fax:
Practice Address - Street 1:231 BENDIGO BLVD N
Practice Address - Street 2:
Practice Address - City:NORTH BEND
Practice Address - State:WA
Practice Address - Zip Code:98045-8259
Practice Address - Country:US
Practice Address - Phone:206-552-9756
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-10
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty