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General NPI Number Information
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NPI Number | 1265834568
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Entity Type | Individual
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Provider Name | SAMARA WHITE EAMP, LAC, LMP
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Gender | Female
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Dates
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Enumeration Date | 09/18/2014
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Last Update Date | 09/29/2014
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Provider Practice Location Address
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Address Line | 4206 STONE WAY N
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City | SEATTLE
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State | WA
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Zip | 98103-7431
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Country | US
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Telephone | 206-395-9796
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Fax |
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Provider Business Mailing Address
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Address Line | 413 NE 70TH ST UNIT 328
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City | SEATTLE
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State | WA
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Zip | 98115-5486
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Country | US
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Telephone | 206-395-9796
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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 | AC60503724
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA60461701
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License Number State | WA
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