Healthcare Provider Details

I. General information

NPI: 1427147925
Provider Name (Legal Business Name): YING WANG L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 16TH AVE E 2ND FLR
SEATTLE WA
98112-5212
US

IV. Provider business mailing address

3627 80TH AVE SE
MERCER ISLAND WA
98040-3523
US

V. Phone/Fax

Practice location:
  • Phone: 206-292-2277
  • Fax: 206-292-2015
Mailing address:
  • Phone: 206-230-5658
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC00000285
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: