Healthcare Provider Details

I. General information

NPI: 1831751676
Provider Name (Legal Business Name): PEKOE ACUPUNCTURE AND WELLNESS CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2019
Last Update Date: 07/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1410 9TH ST NW STE 1
WASHINGTON DC
20001-3361
US

IV. Provider business mailing address

1410 9TH ST NW STE 1
WASHINGTON DC
20001-3361
US

V. Phone/Fax

Practice location:
  • Phone: 202-408-4858
  • Fax: 202-408-4857
Mailing address:
  • Phone: 202-408-4858
  • Fax: 202-408-4857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. NICOLE INGRID MIRES
Title or Position: OWNER, ACUPUNCTURISTT
Credential: L.AC
Phone: 202-408-4858