Provider Demographics
NPI:1740560176
Name:SITTING SWAN LLC
Entity Type:Organization
Organization Name:SITTING SWAN LLC
Other - Org Name:SITTING SWAN ACUPUNCTURE AND HEALING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:907-376-7284
Mailing Address - Street 1:920 E SNOHOMISH AVE
Mailing Address - Street 2:APARTMENT A
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-5714
Mailing Address - Country:US
Mailing Address - Phone:907-376-7284
Mailing Address - Fax:
Practice Address - Street 1:3161 E PALMER WASILLA HWY
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7271
Practice Address - Country:US
Practice Address - Phone:907-357-1818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-16
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK132261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service