MEDICARE: COMMUNITY ACUPUNCTURE PROJECT

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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1891139242
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY ACUPUNCTURE PROJECT

Provider Business Mailing Address
First Line	:	3811 S FERDINAND ST APT B
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98118-1759
Country	:	US
Telephone Number	:	206-760-6064
Fax Number	:

Provider Business Practice Location Address
First Line	:	3811 S FERDINAND ST APT B
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98118-1759
Country	:	US
Telephone Number	:	206-760-6064
Fax Number	:

Authorized Official
Title or Position	:	PROPRIETOR
Name	:	MS. SONJA SIVESIND
Credential	:	EAMP, L.AC
Telephone Number	:	206-760-6064

Provider Enumeration Date	:	04/28/2013
Last Update Date	:	04/28/2013

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