Healthcare Provider Details

I. General information

NPI: 1801985437
Provider Name (Legal Business Name): ELIZABETH M ARTOLA LAC
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

3320 W MCGRAW ST
SEATTLE WA
98199
US

IV. Provider business mailing address

3320 W MCGRAW ST
SEATTLE WA
98199
US

V. Phone/Fax

Practice location:
  • Phone: 206-283-9935
  • Fax: 206-283-9935
Mailing address:
  • Phone: 206-283-9910
  • Fax: 206-283-9935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC00002233
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: