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General NPI Number Information
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NPI Number | 1114201902
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Entity Type | Individual
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Provider Name | MONICA GILLIAM L.AC., E.A.M.P.,
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Gender | Female
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Dates
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Enumeration Date | 09/28/2011
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Last Update Date | 09/28/2011
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Provider Practice Location Address
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Address Line | 6700 15TH AVE NW
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City | SEATTLE
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State | WA
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Zip | 98117-5507
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Country | US
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Telephone | 206-784-3493
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Fax |
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Provider Business Mailing Address
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Address Line | 311 15TH AVE
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City | SEATTLE
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State | WA
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Zip | 98122-5605
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Country | US
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Telephone | 206-353-6403
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | AC60246513
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License Number State | WA
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