Healthcare Provider Details

I. General information

NPI: 1023174190
Provider Name (Legal Business Name): WENDY FUEI-WEN HUNG L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6329 15TH AVE NE
SEATTLE WA
98115-6803
US

IV. Provider business mailing address

6812 147TH CT NE
REDMOND WA
98052-4608
US

V. Phone/Fax

Practice location:
  • Phone: 425-770-0676
  • Fax:
Mailing address:
  • Phone: 425-770-0676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC 610
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: