Healthcare Provider Details

I. General information

NPI: 1225211683
Provider Name (Legal Business Name): KALIN HUDDLESTON GARCIA EAME (L.AC.)
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. KALIN SUZANNE HUDDLESTON

II. Dates (important events)

Enumeration Date: 12/07/2007
Last Update Date: 04/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1737 WELLS ST
ENUMCLAW WA
98022-3518
US

IV. Provider business mailing address

PO BOX 131
BUCKLEY WA
98321-0131
US

V. Phone/Fax

Practice location:
  • Phone: 360-825-7549
  • Fax: 360-825-4645
Mailing address:
  • Phone: 360-829-7776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC00002910
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: