Healthcare Provider Details

I. General information

NPI: 1740387992
Provider Name (Legal Business Name): JEFFREY B. THOMPSON L.AC, M.AC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3320 W MCGRAW ST
SEATTLE WA
98199-3241
US

IV. Provider business mailing address

6741 4TH AVE NW
SEATTLE WA
98117-5009
US

V. Phone/Fax

Practice location:
  • Phone: 206-283-9910
  • Fax:
Mailing address:
  • Phone: 206-789-0097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: