Healthcare Provider Details

I. General information

NPI: 1982895777
Provider Name (Legal Business Name): EVA ANDREA GRYNIEWSKI M.AC, L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EVA ANDREA LUNA

II. Dates (important events)

Enumeration Date: 08/06/2007
Last Update Date: 10/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 SW BARTON ST STE E26
SEATTLE WA
98126-3949
US

IV. Provider business mailing address

2600 SW BARTON ST STE E26
SEATTLE WA
98126-3949
US

V. Phone/Fax

Practice location:
  • Phone: 206-334-5693
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC00002725
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: