Provider Demographics
NPI:1598247207
Name:MCGINLEY, KRISTINE MARIE (LAC)
Entity Type:Individual
Prefix:MISS
First Name:KRISTINE
Middle Name:MARIE
Last Name:MCGINLEY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 EAST 33RD ST.
Mailing Address - Street 2:STE 203A
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98663
Mailing Address - Country:US
Mailing Address - Phone:360-258-0587
Mailing Address - Fax:360-253-3961
Practice Address - Street 1:100 EAST 33RD ST.
Practice Address - Street 2:STE 203A
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98663
Practice Address - Country:US
Practice Address - Phone:360-258-0587
Practice Address - Fax:360-253-3961
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60700591171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist