Provider Demographics
NPI:1912071721
Name:MA, XING DONG (OMD, LAC)
Entity Type:Individual
Prefix:DR
First Name:XING
Middle Name:DONG
Last Name:MA
Suffix:
Gender:F
Credentials:OMD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 QUEEN ANNE AVE NORTH #C-101
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109
Mailing Address - Country:US
Mailing Address - Phone:206-363-8160
Mailing Address - Fax:206-284-7199
Practice Address - Street 1:326 QUEEN ANNE AVE N # C-101
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-4558
Practice Address - Country:US
Practice Address - Phone:206-363-8160
Practice Address - Fax:206-284-7199
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00000614171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist