Provider Demographics
NPI:1205455060
Name:FORMOSA ACUPUNCTURE & HERBS CORP
Entity type:Organization
Organization Name:FORMOSA ACUPUNCTURE & HERBS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRACTIONER
Authorized Official - Prefix:
Authorized Official - First Name:WEN-FANG
Authorized Official - Middle Name:
Authorized Official - Last Name:KU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-214-8387
Mailing Address - Street 1:13555 BEL-RED RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13555 BEL-RED RD
Practice Address - Street 2:SUITE 110
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005
Practice Address - Country:US
Practice Address - Phone:425-362-6159
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-13
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center