Provider Demographics
NPI:1609589878
Name:JASMINE PEARL ACUPUNCTURE
Entity Type:Organization
Organization Name:JASMINE PEARL ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:LEILANI
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOUSTON
Authorized Official - Suffix:
Authorized Official - Credentials:LAC MSTCM
Authorized Official - Phone:303-736-9117
Mailing Address - Street 1:677 S DEPEW ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-4849
Mailing Address - Country:US
Mailing Address - Phone:303-217-1402
Mailing Address - Fax:
Practice Address - Street 1:12995 SHERIDAN BLVD STE 101
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-1488
Practice Address - Country:US
Practice Address - Phone:303-736-9117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
1649711136OtherBCBS