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General NPI Number Information
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NPI Number | 1548766058
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE INJURY CLINIC, PS
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Dates
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Enumeration Date | 04/03/2018
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Last Update Date | 06/03/2021
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Provider Practice Location Address
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Address Line | 900 S JACKSON ST STE 115
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City | SEATTLE
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State | WA
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Zip | 98104-3056
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Country | US
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Telephone | 206-736-6686
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 14136
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City | SEATTLE
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State | WA
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Zip | 98114-0136
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Country | US
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Telephone | 206-736-6686
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL CHAN
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Credential |
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Telephone | 206-736-6686
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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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Taxonomy #2
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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