Healthcare Provider Details

I. General information

NPI: 1912810037
Provider Name (Legal Business Name): DAVID MICHAEL FIEDLER LAC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3412 125TH PL SE
EVERETT WA
98208-6198
US

IV. Provider business mailing address

3412 125TH PL SE
EVERETT WA
98208-6198
US

V. Phone/Fax

Practice location:
  • Phone: 425-870-2157
  • Fax:
Mailing address:
  • Phone: 425-870-2157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC00001833
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: