Provider Demographics
NPI:1619384559
Name:LOPEZ ACUPUNCTURE @ INTEGRATED HEALTH
Entity Type:Organization
Organization Name:LOPEZ ACUPUNCTURE @ INTEGRATED HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIENNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BATTALIA
Authorized Official - Suffix:
Authorized Official - Credentials:EAMP, LAC, LMP
Authorized Official - Phone:360-468-3239
Mailing Address - Street 1:2108 FISHERMAN BAY RD APT D
Mailing Address - Street 2:
Mailing Address - City:LOPEZ ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98261-8519
Mailing Address - Country:US
Mailing Address - Phone:360-468-3239
Mailing Address - Fax:
Practice Address - Street 1:210 LOPEZ ROAD
Practice Address - Street 2:
Practice Address - City:LOPEZ ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98261-8519
Practice Address - Country:US
Practice Address - Phone:360-468-3239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-11
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60074458171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1184761504OtherNPI