Provider Demographics
NPI:1609629211
Name:THE ACUPUNCTURE COLLECTIVE
Entity Type:Organization
Organization Name:THE ACUPUNCTURE COLLECTIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLAND
Authorized Official - Suffix:
Authorized Official - Credentials:DAOM
Authorized Official - Phone:360-787-1887
Mailing Address - Street 1:14610 NE 186TH AVE
Mailing Address - Street 2:
Mailing Address - City:BRUSH PRAIRIE
Mailing Address - State:WA
Mailing Address - Zip Code:98606-5105
Mailing Address - Country:US
Mailing Address - Phone:360-787-1887
Mailing Address - Fax:
Practice Address - Street 1:6923 NW FRIBERG STRUNK ST STE 140
Practice Address - Street 2:
Practice Address - City:CAMAS
Practice Address - State:WA
Practice Address - Zip Code:98607-7796
Practice Address - Country:US
Practice Address - Phone:360-787-1887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center