Provider Demographics
NPI:1851423909
Name:SUMMERS, NATHAN RICHARD (LAC LICENSED ACUPUNC)
Entity Type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:RICHARD
Last Name:SUMMERS
Suffix:
Gender:M
Credentials:LAC LICENSED ACUPUNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5837 221ST PLACE SE
Mailing Address - Street 2:RIVER VALLEY
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027
Mailing Address - Country:US
Mailing Address - Phone:206-431-5336
Mailing Address - Fax:
Practice Address - Street 1:5837 221ST PLACE SE
Practice Address - Street 2:RIVER VALLEY
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027
Practice Address - Country:US
Practice Address - Phone:206-431-5336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00001858171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist