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General NPI Number Information
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NPI Number | 1144416249
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Entity Type | Individual
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Provider Name | SHIRLIEY FUNG L.AC., MACOM
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Gender | Female
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Dates
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Enumeration Date | 09/21/2007
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Last Update Date | 09/21/2007
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Provider Practice Location Address
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Address Line | 8009 S 180TH ST #104
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City | KENT
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State | WA
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Zip | 98032-1042
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Country | US
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Telephone | 206-550-5206
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Fax |
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Provider Business Mailing Address
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Address Line | 16860 SE 171ST PL
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City | RENTON
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State | WA
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Zip | 98058-4200
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Country | US
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Telephone | 206-550-5206
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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 | AC00002909
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License Number State | WA
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