Provider Demographics
NPI:1295160802
Name:JEAN-LOUIS, GALIE LOUISE (LAC)
Entity type:Individual
Prefix:
First Name:GALIE
Middle Name:LOUISE
Last Name:JEAN-LOUIS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:GALIE
Other - Middle Name:LOUISE
Other - Last Name:JEAN-LOUIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:EAMP, LAC
Mailing Address - Street 1:28 SHOREWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-7752
Mailing Address - Country:US
Mailing Address - Phone:360-739-0798
Mailing Address - Fax:
Practice Address - Street 1:28 SHOREWOOD DR
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-7752
Practice Address - Country:US
Practice Address - Phone:360-739-0798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-13
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60411688171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist