Provider Demographics
NPI:1922536309
Name:WARE, WILLIAM NOEL (LAC)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:NOEL
Last Name:WARE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3704 SARATOGA RD
Mailing Address - Street 2:
Mailing Address - City:LANGLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98260-9654
Mailing Address - Country:US
Mailing Address - Phone:510-502-5261
Mailing Address - Fax:
Practice Address - Street 1:3704 SARATOGA RD
Practice Address - Street 2:
Practice Address - City:LANGLEY
Practice Address - State:WA
Practice Address - Zip Code:98260-9654
Practice Address - Country:US
Practice Address - Phone:510-502-5261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-30
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC61018804171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist