Provider Demographics
NPI:1891853032
Name:BURNIKEL, CANDACE J (LAC)
Entity Type:Individual
Prefix:MR
First Name:CANDACE
Middle Name:J
Last Name:BURNIKEL
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2425 SW 306TH PL
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-2339
Mailing Address - Country:US
Mailing Address - Phone:206-251-3295
Mailing Address - Fax:
Practice Address - Street 1:900 S 336TH ST
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6311
Practice Address - Country:US
Practice Address - Phone:206-251-3295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00002359171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist