=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548278823
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | QIJIAN YE L.AC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/03/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 32114 1ST AVE S SUITE 104
-----------------------------------------------------
City | FEDERAL WAY
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98003-5760
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 253-632-1530
-----------------------------------------------------
Fax | 253-874-7483
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2711 SW 310TH ST
-----------------------------------------------------
City | FEDERAL WAY
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98023-7870
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 253-632-1530
-----------------------------------------------------
Fax | 253-874-7483
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | 261
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------