=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386861037
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANIEL JOSEPH ZIZZA L.AC.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/20/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 613 19TH AVE E STE 202
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98112-4000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-329-5466
-----------------------------------------------------
Fax | 206-720-6286
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 613 19TH AVE E STE 202
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98112-4000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-329-5466
-----------------------------------------------------
Fax | 206-720-6286
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | 00000055
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------