Healthcare Provider Details

I. General information

NPI: 1811701428
Provider Name (Legal Business Name): ANDREW HALL MT, L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2025
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 N 85TH ST
SEATTLE WA
98103-3721
US

IV. Provider business mailing address

8013 16TH AVE NW
SEATTLE WA
98117-3608
US

V. Phone/Fax

Practice location:
  • Phone: 206-900-8883
  • Fax:
Mailing address:
  • Phone: 307-203-0198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC.61634179
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number61635401
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: