Provider Demographics
NPI:1417594375
Name:EASTERN MEDICINE I-CHING ACUPUNCTURE CLINIC, PLLC
Entity Type:Organization
Organization Name:EASTERN MEDICINE I-CHING ACUPUNCTURE CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:XIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHE
Authorized Official - Suffix:
Authorized Official - Credentials:DAOM, LAC
Authorized Official - Phone:626-592-0910
Mailing Address - Street 1:13225 44TH AVE W
Mailing Address - Street 2:
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275-5907
Mailing Address - Country:US
Mailing Address - Phone:626-592-0910
Mailing Address - Fax:
Practice Address - Street 1:7935 216TH ST SW STE E
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7941
Practice Address - Country:US
Practice Address - Phone:425-672-2113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-10
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty