Provider Demographics
NPI:1851715015
Name:SUZUKI, KEELAN AKIYOSHI (MS, LAC, EAMP)
Entity Type:Individual
Prefix:
First Name:KEELAN
Middle Name:AKIYOSHI
Last Name:SUZUKI
Suffix:
Gender:M
Credentials:MS, LAC, EAMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 124TH AVE NE
Mailing Address - Street 2:SUITE #111
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-1934
Mailing Address - Country:US
Mailing Address - Phone:425-818-8248
Mailing Address - Fax:
Practice Address - Street 1:2100 124TH AVE NE
Practice Address - Street 2:SUITE #111
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-1934
Practice Address - Country:US
Practice Address - Phone:425-818-8248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-08
Last Update Date:2014-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC 60430126171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist