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General NPI Number Information
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NPI Number | 1235474974
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Entity Type | Organization
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Legal Business Name | OPTIMUM ACUPUNCTURE & CHIROPRACTIC CLINIC INC
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Dates
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Enumeration Date | 12/06/2012
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Last Update Date | 12/06/2012
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Provider Practice Location Address
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Address Line | 506 NE 65TH ST
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City | SEATTLE
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State | WA
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Zip | 98115-6412
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Country | US
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Telephone | 206-547-3127
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Fax | 206-547-8525
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Provider Business Mailing Address
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Address Line | 506 NE 65TH ST
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City | SEATTLE
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State | WA
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Zip | 98115-6412
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Country | US
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Telephone | 206-547-3127
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Fax | 206-547-8525
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTINE ALAINE MESHEW
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Credential | D.C., M.A.
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Telephone | 206-399-9303
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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 | 0009829807
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 0004419084
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License Number State | WA
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