Provider Demographics
NPI:1821149295
Name:FIELD, LORI G (L AC, OTR)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:G
Last Name:FIELD
Suffix:
Gender:F
Credentials:L AC, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17409 106TH PL NE
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-3779
Mailing Address - Country:US
Mailing Address - Phone:425-482-2306
Mailing Address - Fax:
Practice Address - Street 1:12900 NE 180TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-5773
Practice Address - Country:US
Practice Address - Phone:425-443-0831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00002633171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist