Provider Demographics
NPI:1750478939
Name:ADOLFO, TERI LYN (L AC)
Entity Type:Individual
Prefix:
First Name:TERI
Middle Name:LYN
Last Name:ADOLFO
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 N 36TH ST
Mailing Address - Street 2:SUITE 330
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103
Mailing Address - Country:US
Mailing Address - Phone:206-218-2610
Mailing Address - Fax:206-632-4907
Practice Address - Street 1:701 N 36TH ST
Practice Address - Street 2:SUITE 330
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103
Practice Address - Country:US
Practice Address - Phone:206-218-2610
Practice Address - Fax:206-632-4907
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00002036171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist