Healthcare Provider Details

I. General information

NPI: 1841379815
Provider Name (Legal Business Name): STACEY LYNN MCCARTHY L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10581 OLD FRONTIER RD NW
SILVERDALE WA
98383-8896
US

IV. Provider business mailing address

2350 EDDY ST
PORT TOWNSEND WA
98368-5956
US

V. Phone/Fax

Practice location:
  • Phone: 360-900-3574
  • Fax: 360-930-0902
Mailing address:
  • Phone: 503-282-5358
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberACUP.AC.61050972
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: