MEDICARE: JULIE JENKINS 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	AC60058151	WA
2	225700000X	Massage Therapist	MA00021474	WA

General Provider Information

NPI Number	:	1780915058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE JENKINS L.AC.

Provider Business Mailing Address
First Line	:	8113 STONE AVE N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-4414
Country	:	US
Telephone Number	:	206-661-6195
Fax Number	:

Provider Business Practice Location Address
First Line	:	8113 STONE AVE N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-4414
Country	:	US
Telephone Number	:	206-661-6195
Fax Number	:

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

Provider Enumeration Date	:	01/26/2010
Last Update Date	:	12/30/2011

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Directions to “ JULIE JENKINS L.AC.” Practice Location

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