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NPI 1194104679

NPI 1194104679 : VICKIE YVONNE WASHINGTON L.AC : SAN FRANCISCO, CA

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General NPI Number Information
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    NPI Number           |    1194104679
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    Entity Type          |    Individual 
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    Provider Name        |    VICKIE YVONNE WASHINGTON L.AC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/29/2015
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    Last Update Date     |    05/29/2015
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Provider Practice Location Address
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    Address Line         |    632 COMMERCIAL ST STE 100 
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    City                 |    SAN FRANCISCO
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    State                |    CA
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    Zip                  |    94111-2573
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    Country              |    US
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    Telephone            |    415-795-8100
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    Fax                  |    415-795-4404
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Provider Business Mailing Address
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    Address Line         |    1561 PACIFIC AVE 
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    City                 |    SAN FRANCISCO
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    State                |    CA
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    Zip                  |    94109-2626
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    Country              |    US
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    Telephone            |    415-269-6320
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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       |    16602
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    License Number State |    CA
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