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General NPI Number Information
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NPI Number | 1639813330
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Entity Type | Organization
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Legal Business Name | ELEVATED ACUPUNCTURE LLC
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Dates
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Enumeration Date | 04/27/2022
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Last Update Date | 04/27/2022
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Provider Practice Location Address
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Address Line | 1500 FAIRVIEW AVE E STE 205
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City | SEATTLE
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State | WA
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Zip | 98102-3727
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Country | US
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Telephone | 253-987-6049
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Fax | 206-325-9292
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Provider Business Mailing Address
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Address Line | 9810 42ND AVE SW
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City | SEATTLE
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State | WA
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Zip | 98136-2819
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Country | US
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Telephone | 303-378-0557
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BETHANY C DEMARCO
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Credential | LAC, MSAOM, RN
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Telephone | 303-378-0557
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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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