=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477604304
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOSIE XI ZHUO LAC LICENSED ACUPUNC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/16/2007
-----------------------------------------------------
Last Update Date | 12/14/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 105 NE 56TH ST
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98105-3737
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-351-5231
-----------------------------------------------------
Fax | 206-545-2927
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4142 WOODLAND PARK AVE N
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98103-7920
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-351-5231
-----------------------------------------------------
Fax | 206-545-2927
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | AC00001966
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------