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General NPI Number Information
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NPI Number | 1447653365
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Entity Type | Organization
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Legal Business Name | ACUPUNCTURE AND CHINESE THERAPEUTICS, LLC
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Dates
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Enumeration Date | 10/06/2014
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Last Update Date | 10/06/2014
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Provider Practice Location Address
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Address Line | 2033 E SIMS WAY
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City | PORT TOWNSEND
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State | WA
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Zip | 98368-6905
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Country | US
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Telephone | 360-344-2957
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Fax |
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Provider Business Mailing Address
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Address Line | 2033 E SIMS WAY
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City | PORT TOWNSEND
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State | WA
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Zip | 98368-6905
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Country | US
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Telephone | 360-344-2957
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Fax |
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Authorized Official
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Title or Position | OWNER, MANAGER
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Name | JANE MARIE HANSEN
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Credential | L.AC, LMT
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Telephone | 360-379-6655
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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 | AC60456929
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License Number State | WA
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