Healthcare Provider Details

I. General information

NPI: 1831585025
Provider Name (Legal Business Name): 180 HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2015
Last Update Date: 04/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N 36TH ST STE 320
SEATTLE WA
98103-8698
US

IV. Provider business mailing address

600 N 36TH ST STE 320
SEATTLE WA
98103-8698
US

V. Phone/Fax

Practice location:
  • Phone: 206-669-1707
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ZACHARY FULTON
Title or Position: EAST ASIAN MEDICINE PRACTITIONER
Credential: EAMP
Phone: 206-669-1707