Healthcare Provider Details

I. General information

NPI: 1881946473
Provider Name (Legal Business Name): CHUN CHENG LEAMP, LAC, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2012
Last Update Date: 10/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10516 E RIVERSIDE DR
BOTHELL WA
98011-3714
US

IV. Provider business mailing address

10516 E RIVERSIDE DR
BOTHELL WA
98011-3714
US

V. Phone/Fax

Practice location:
  • Phone: 425-702-9282
  • Fax: 425-286-6018
Mailing address:
  • Phone: 425-702-9282
  • Fax: 425-286-6018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC60309824
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: