Healthcare Provider Details

I. General information

NPI: 1609642982
Provider Name (Legal Business Name): SUNRISE ACUPUNCTURE AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2023
Last Update Date: 11/28/2023
Certification Date: 11/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14042 NE 8TH ST STE 204
BELLEVUE WA
98007-4142
US

IV. Provider business mailing address

14042 NE 8TH ST STE 204
BELLEVUE WA
98007-4142
US

V. Phone/Fax

Practice location:
  • Phone: 425-224-6799
  • Fax:
Mailing address:
  • Phone: 425-224-6799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: XIAOTONG WANG
Title or Position: OWNER
Credential:
Phone: 425-420-7911