Provider Demographics
NPI:1508197468
Name:NECTAR ACUPUNCTURE & INTEGRATED THERAPEUTICS
Entity Type:Organization
Organization Name:NECTAR ACUPUNCTURE & INTEGRATED THERAPEUTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST AND MASSAGE
Authorized Official - Prefix:MS
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:OLIVIA
Authorized Official - Last Name:SOLLEK
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, LMP
Authorized Official - Phone:206-291-2810
Mailing Address - Street 1:2808 HARRIS PL S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-5924
Mailing Address - Country:US
Mailing Address - Phone:206-291-2810
Mailing Address - Fax:
Practice Address - Street 1:704 WARREN AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-4027
Practice Address - Country:US
Practice Address - Phone:206-291-2810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-15
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60062789171100000X
WAMA00017680225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty