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General NPI Number Information
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NPI Number | 1205455060
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Entity Type | Organization
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Legal Business Name | FORMOSA ACUPUNCTURE & HERBS CORP
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Dates
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Enumeration Date | 04/13/2020
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Last Update Date | 06/05/2023
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Provider Practice Location Address
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Address Line | 13555 BEL-RED RD SUITE 110
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City | BELLEVUE
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State | WA
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Zip | 98005
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Country | US
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Telephone | 425-362-6159
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Fax |
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Provider Business Mailing Address
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Address Line | 13555 BEL-RED RD SUITE 110
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City | BELLEVUE
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State | WA
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Zip | 98005
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER, PRACTIONER
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Name | WEN-FANG KU
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Credential |
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Telephone | 206-214-8387
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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