MEDICARE: CHARLIE FEIMAN YEN L.AC

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	AC61006135	WA

General Provider Information

NPI Number	:	1699315275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLIE FEIMAN YEN L.AC

Provider Business Mailing Address
First Line	:	626 S JACKSON ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98104-2911
Country	:	US
Telephone Number	:	206-696-9176
Fax Number	:

Provider Business Practice Location Address
First Line	:	626 S JACKSON ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98104-2911
Country	:	US
Telephone Number	:	206-696-9176
Fax Number	:

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

Provider Enumeration Date	:	01/10/2020
Last Update Date	:	01/10/2020

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