Provider Demographics
NPI:1184928103
Name:ACUPUNCTURE WHOLE HEALTH CENTER
Entity type:Organization
Organization Name:ACUPUNCTURE WHOLE HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PHAM
Authorized Official - Suffix:
Authorized Official - Credentials:RN, EAMP
Authorized Official - Phone:509-294-4907
Mailing Address - Street 1:3303 S. LLOYD LN
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223
Mailing Address - Country:US
Mailing Address - Phone:509-294-4907
Mailing Address - Fax:
Practice Address - Street 1:2204 E 29TH AVE STE 208
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-3961
Practice Address - Country:US
Practice Address - Phone:509-294-4907
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-05
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00003095171100000X
WAAC60187384171100000X
WARN80187077251J00000X, 252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
No251J00000XAgenciesNursing Care
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Single Specialty