Healthcare Provider Details

I. General information

NPI: 1689877276
Provider Name (Legal Business Name): RAMEY ELISABETH FAIR MAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 10TH AVE E
SEATTLE WA
98102-5720
US

IV. Provider business mailing address

3959 S FERDINAND ST
SEATTLE WA
98118-1739
US

V. Phone/Fax

Practice location:
  • Phone: 206-755-4949
  • Fax:
Mailing address:
  • Phone: 206-721-0142
  • Fax: 206-861-8305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC00000729
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: