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General NPI Number Information
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NPI Number | 1013324037
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Entity Type | Organization
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Legal Business Name | BALLARD ACUPUNCTURE CENTER LLC
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Dates
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Enumeration Date | 07/22/2014
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Last Update Date | 07/22/2014
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Provider Practice Location Address
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Address Line | 2224 NW 56TH ST
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City | SEATTLE
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State | WA
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Zip | 98107-4059
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Country | US
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Telephone | 206-491-7746
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Fax |
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Provider Business Mailing Address
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Address Line | 2224 NW 56TH ST
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City | SEATTLE
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State | WA
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Zip | 98107-4059
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Country | US
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Telephone | 206-491-7746
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. AVIGAIL COHEN
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Credential | L.AC.
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Telephone | 206-491-7746
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC2285
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License Number State | WA
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