Provider Demographics
NPI:1245494913
Name:WENG, SAM TSU-YIN (LAC)
Entity type:Individual
Prefix:MR
First Name:SAM
Middle Name:TSU-YIN
Last Name:WENG
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 1:15650 NE 24TH ST
Mailing Address - Street 2:SUITE C2
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98008-2460
Mailing Address - Country:US
Mailing Address - Phone:206-427-3799
Mailing Address - Fax:
Practice Address - Street 1:15650 NE 24TH ST
Practice Address - Street 2:SUITE C2
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98008-2460
Practice Address - Country:US
Practice Address - Phone:206-427-3799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00003068171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist