Healthcare Provider Details
I. General information
NPI: 1639205313
Provider Name (Legal Business Name): JAY ZHOU MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10212 5TH AVE NE STE 140
SEATTLE WA
98125-7471
US
IV. Provider business mailing address
3521 NE 93RD ST
SEATTLE WA
98115-3663
US
V. Phone/Fax
- Phone: 206-527-9937
- Fax:
- Phone: 206-412-8678
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | MD00046227 |
| License Number State | WA |
VIII. Authorized Official
Name:
JIEGANG
ZHOU
Title or Position: PRESIDENT
Credential:
Phone: 206-412-8678