Provider Demographics
NPI:1689991093
Name:KRASSOWSKI, WITOLD III (MSAOM, LAC)
Entity Type:Individual
Prefix:
First Name:WITOLD
Middle Name:
Last Name:KRASSOWSKI
Suffix:III
Gender:M
Credentials:MSAOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3130 E MADISON ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-4264
Mailing Address - Country:US
Mailing Address - Phone:206-328-3058
Mailing Address - Fax:
Practice Address - Street 1:3130 E MADISON ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-4264
Practice Address - Country:US
Practice Address - Phone:206-328-3058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-24
Last Update Date:2010-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60136700171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist