Provider Demographics
NPI:1619249828
Name:CEIBA ACUPUNCTURE & BODYWORK LLC
Entity Type:Organization
Organization Name:CEIBA ACUPUNCTURE & BODYWORK LLC
Other - Org Name:9 CROWS HERBAL HEALING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACUPUNCTURIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:EAMP, LMP
Authorized Official - Phone:206-304-2343
Mailing Address - Street 1:1418 S 234TH ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:WA
Mailing Address - Zip Code:98198-7493
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:204 S 348TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-7041
Practice Address - Country:US
Practice Address - Phone:206-304-2343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-02
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60065362171100000X
WAMA00023205172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No172M00000XOther Service ProvidersMechanotherapistGroup - Multi-Specialty