Provider Demographics
NPI:1780110627
Name:CHERRY BLOSSOM HEALING ARTS
Entity type:Organization
Organization Name:CHERRY BLOSSOM HEALING ARTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LICENSED ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:ELYSE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROHRER BUDIASH
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, MSOM, DIPLOM
Authorized Official - Phone:202-681-1588
Mailing Address - Street 1:2639 CONNECTICUT AVE NW
Mailing Address - Street 2:SUITE C-101
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-1537
Mailing Address - Country:US
Mailing Address - Phone:202-681-1588
Mailing Address - Fax:
Practice Address - Street 1:2639 CONNECTICUT AVE NW
Practice Address - Street 2:SUITE C-101
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-1537
Practice Address - Country:US
Practice Address - Phone:202-681-1588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCAC500183171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty