MEDICARE: STEPHANIE KARDOS LAC., LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	61370049	WA
2	225700000X	Massage Therapist	60344647	WA

General Provider Information

NPI Number	:	1548521735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE KARDOS LAC., LMT

Provider Business Mailing Address
First Line	:	2120 1ST AVE N # B10
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98109-2301
Country	:	US
Telephone Number	:	206-414-8115
Fax Number	:

Provider Business Practice Location Address
First Line	:	2120 1ST AVE N # B10
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98109-2301
Country	:	US
Telephone Number	:	206-414-8115
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2012
Last Update Date	:	11/14/2022

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Directions to “ STEPHANIE KARDOS LAC., LMT” Practice Location

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