Provider Demographics
NPI: | 1811384456 |
---|---|
Name: | GENTLE POINT PLLC |
Entity Type: | Organization |
Organization Name: | GENTLE POINT PLLC |
Other - Org Name: | SEATTLE CARE CLINIC |
Other - Org Type: | Other Name |
Authorized Official - Title/Position: | ACUPUNCTURIST |
Authorized Official - Prefix: | |
Authorized Official - First Name: | RYAN |
Authorized Official - Middle Name: | M |
Authorized Official - Last Name: | LAW |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | EAMP MACOM |
Authorized Official - Phone: | 206-310-0761 |
Mailing Address - Street 1: | 1205 E PIKE ST STE 2J |
Mailing Address - Street 2: | |
Mailing Address - City: | SEATTLE |
Mailing Address - State: | WA |
Mailing Address - Zip Code: | 98122-3932 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 206-310-0761 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1205 E PIKE ST STE 2J |
Practice Address - Street 2: | |
Practice Address - City: | SEATTLE |
Practice Address - State: | WA |
Practice Address - Zip Code: | 98122-3932 |
Practice Address - Country: | US |
Practice Address - Phone: | 206-310-0761 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2015-04-21 |
Last Update Date: | 2015-04-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
WA | AC60311050 | 171100000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 171100000X | Other Service Providers | Acupuncturist | Group - Multi-Specialty |