Provider Demographics
NPI:1417176850
Name:TJOA, MAIHWA (DC LAC)
Entity Type:Individual
Prefix:
First Name:MAIHWA
Middle Name:
Last Name:TJOA
Suffix:
Gender:F
Credentials:DC LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2747 PACIFIC AVE SE
Mailing Address - Street 2:SUITE A-12
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-2097
Mailing Address - Country:US
Mailing Address - Phone:360-943-6797
Mailing Address - Fax:360-943-6785
Practice Address - Street 1:2747 PACIFIC AVE SE
Practice Address - Street 2:SUITE A-12
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-2097
Practice Address - Country:US
Practice Address - Phone:360-943-6797
Practice Address - Fax:360-943-6785
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00003207111N00000X
WAAC00000530171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered171100000XOther Service ProvidersAcupuncturist