Provider Demographics
NPI:1982895777
Name:GRYNIEWSKI, EVA ANDREA (MAC, LAC)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:ANDREA
Last Name:GRYNIEWSKI
Suffix:
Gender:F
Credentials:MAC, LAC
Other - Prefix:
Other - First Name:EVA
Other - Middle Name:ANDREA
Other - Last Name:LUNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2600 SW BARTON ST STE E26
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98126-3949
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2600 SW BARTON ST STE E26
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98126-3949
Practice Address - Country:US
Practice Address - Phone:206-334-5693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00002725171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist