Healthcare Provider Details

I. General information

NPI: 1457639205
Provider Name (Legal Business Name): HAILAN CUI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2011
Last Update Date: 07/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1595 NW GILMAN BLVD STE 8B
ISSAQUAH WA
98027-5329
US

IV. Provider business mailing address

1595 NW GILMAN BLVD STE 8B
ISSAQUAH WA
98027-5329
US

V. Phone/Fax

Practice location:
  • Phone: 425-223-6118
  • Fax:
Mailing address:
  • Phone: 425-223-6118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC60128074
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: