Healthcare Provider Details

I. General information

NPI: 1083570899
Provider Name (Legal Business Name): CRAIG MITCHELL ACUPUNCTURIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/25/2025
Last Update Date: 12/25/2025
Certification Date: 12/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6363 7TH AVE S STE 100
SEATTLE WA
98108-3407
US

IV. Provider business mailing address

5215 48TH AVE S
SEATTLE WA
98118-2320
US

V. Phone/Fax

Practice location:
  • Phone: 206-517-4541
  • Fax:
Mailing address:
  • Phone: 206-595-7488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC00002043
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: