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General NPI Number Information
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NPI Number | 1477848943
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Entity Type | Individual
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Provider Name | FARSHAD ANSARI LAC
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Gender | Male
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Dates
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Enumeration Date | 06/13/2011
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Last Update Date | 10/26/2013
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Provider Practice Location Address
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Address Line | 634 7TH AVE
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City | KIRKLAND
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State | WA
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Zip | 98033-5665
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Country | US
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Telephone | 425-822-2858
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Fax |
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Provider Business Mailing Address
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Address Line | 11422 NE 86TH ST
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City | KIRKLAND
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State | WA
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Zip | 98033-5702
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Country | US
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Telephone | 425-827-0583
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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 | AC60328922
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License Number State | WA
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