Provider Demographics
NPI:1669508909
Name:TURETSKY, TODD (LAC)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:
Last Name:TURETSKY
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 MEADE AVE
Mailing Address - Street 2:
Mailing Address - City:PROSSER
Mailing Address - State:WA
Mailing Address - Zip Code:99350-1423
Mailing Address - Country:US
Mailing Address - Phone:509-786-3637
Mailing Address - Fax:509-786-7385
Practice Address - Street 1:1209 MEADE AVE
Practice Address - Street 2:
Practice Address - City:PROSSER
Practice Address - State:WA
Practice Address - Zip Code:99350-1423
Practice Address - Country:US
Practice Address - Phone:509-786-3637
Practice Address - Fax:509-786-7385
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60201771171100000X
WATP60201771171100000X
CAAC6556171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAC60201771OtherACUPUNCTURE LICENSE
CAAC6556OtherLICENSE NUMBER
WATP60205257OtherACUPUNCTURE LICENSE