Healthcare Provider Details

I. General information

NPI: 1962574384
Provider Name (Legal Business Name): CHRISTIAN GWIN HUNT MACOM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

469 N 36TH ST STE C
SEATTLE WA
98103-8671
US

IV. Provider business mailing address

469 N 36TH ST STE C
SEATTLE WA
98103-8671
US

V. Phone/Fax

Practice location:
  • Phone: 206-547-1104
  • Fax:
Mailing address:
  • Phone: 206-547-1104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: