Healthcare Provider Details

I. General information

NPI: 1861532830
Provider Name (Legal Business Name): QIANG CAO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 01/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8034 35TH AVE. NE
SEATTLE WA
98115
US

IV. Provider business mailing address

8034 35TH AVE. NE
SEATTLE WA
98115
US

V. Phone/Fax

Practice location:
  • Phone: 206-525-1328
  • Fax: 206-524-2276
Mailing address:
  • Phone: 206-525-1328
  • Fax: 206-524-2276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC00000057
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: