Provider Demographics
NPI:1922506047
Name:HEALING ACUPUNCTURE AND HERBAL MEDICINE
Entity Type:Organization
Organization Name:HEALING ACUPUNCTURE AND HERBAL MEDICINE
Other - Org Name:SEATTLE HEALING ACUPUNCTURE, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EAMP/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CLOSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-783-1912
Mailing Address - Street 1:PO BOX 78193
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98178-0193
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1307 N 45TH ST STE 204
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-6741
Practice Address - Country:US
Practice Address - Phone:206-783-1912
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-23
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00002019171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty