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General NPI Number Information
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NPI Number | 1417594375
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Entity Type | Organization
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Legal Business Name | EASTERN MEDICINE I-CHING ACUPUNCTURE CLINIC, PLLC
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Dates
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Enumeration Date | 12/10/2019
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Last Update Date | 12/10/2019
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Provider Practice Location Address
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Address Line | 7935 216TH ST SW STE E
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City | EDMONDS
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State | WA
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Zip | 98026-7941
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Country | US
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Telephone | 425-672-2113
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Fax |
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Provider Business Mailing Address
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Address Line | 13225 44TH AVE W
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City | MUKILTEO
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State | WA
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Zip | 98275-5907
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Country | US
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Telephone | 626-592-0910
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | XIA CHE
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Credential | DAOM, L.AC.
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Telephone | 626-592-0910
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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 |
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License Number State |
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