Provider Demographics
NPI:1457747040
Name:CARMEN L WITTE LEAMPRDH
Entity Type:Organization
Organization Name:CARMEN L WITTE LEAMPRDH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:L.AC.
Authorized Official - Prefix:MS
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:WITTE
Authorized Official - Suffix:
Authorized Official - Credentials:EAMP
Authorized Official - Phone:360-306-0036
Mailing Address - Street 1:851 COHO WAY
Mailing Address - Street 2:SUITE 306
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-2067
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:851 COHO WAY
Practice Address - Street 2:SUITE 306
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-2067
Practice Address - Country:US
Practice Address - Phone:360-306-0036
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-09
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60434453171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty