Healthcare Provider Details

I. General information

NPI: 1073477097
Provider Name (Legal Business Name): ROBIN SAMANTHA KASS LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2025
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2719 E MADISON ST STE 203
SEATTLE WA
98112-4752
US

IV. Provider business mailing address

11501 15TH AVE NE APT 319
SEATTLE WA
98125-6323
US

V. Phone/Fax

Practice location:
  • Phone: 206-568-7545
  • Fax:
Mailing address:
  • Phone: 224-688-7765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberACUP.AC.70072852
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: