Healthcare Provider Details

I. General information

NPI: 1285561878
Provider Name (Legal Business Name): ETHAN SEAMAN ACUPUNCTURE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 MILLER AVE
MILL VALLEY CA
94941-2817
US

IV. Provider business mailing address

1518 EDITH ST
BERKELEY CA
94703-1124
US

V. Phone/Fax

Practice location:
  • Phone: 510-200-8654
  • Fax:
Mailing address:
  • Phone: 510-200-8654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: ETHAN SEAMAN
Title or Position: PRESIDENT / ACUPUNCTURIST
Credential: LAC
Phone: 510-200-8654