Healthcare Provider Details
I. General information
NPI: 1942773767
Provider Name (Legal Business Name): CAO & LAN ACUPUNCTURE BOTANICAL MEDICINE, L. L. C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/03/2019
Last Update Date: 01/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8034 35TH AVE NE
SEATTLE WA
98115-4815
US
IV. Provider business mailing address
8034 35TH AVE NE
SEATTLE WA
98115-4815
US
V. Phone/Fax
- Phone: 206-525-1328
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
HAI
LAN
Title or Position: CLINIC DIRECTOR/PRACTITIONER
Credential: EAMP
Phone: 206-525-1328