Healthcare Provider Details

I. General information

NPI: 1265974927
Provider Name (Legal Business Name): YUN XIAO LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/12/2016
Last Update Date: 12/09/2021
Certification Date: 12/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8034 35TH AVE NE
SEATTLE WA
98115-4815
US

IV. Provider business mailing address

8034 35TH AVE NE
SEATTLE WA
98115-4815
US

V. Phone/Fax

Practice location:
  • Phone: 206-525-1328
  • Fax:
Mailing address:
  • Phone: 206-525-1328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC60890368
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA60691165
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: