Provider Demographics
NPI:1831240282
Name:NW ALTERNATIVE HEALING CENTER INC.
Entity type:Organization
Organization Name:NW ALTERNATIVE HEALING CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YIXIONG
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-528-1038
Mailing Address - Street 1:3316 NE 125TH ST STE 5
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-4565
Mailing Address - Country:US
Mailing Address - Phone:206-528-1038
Mailing Address - Fax:
Practice Address - Street 1:3316 NE 125TH ST STE 5
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-4565
Practice Address - Country:US
Practice Address - Phone:206-528-1038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-14
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00000182171100000X
WAMD00046227208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1126127Medicaid
WA1689725038Other171100000X
WAAC000182OtherACUPUNCTURIST
WA1126127Medicaid