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General NPI Number Information
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NPI Number | 1659442762
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Entity Type | Individual
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Provider Name | JASON WANG C.A., DIPL. AC.
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Gender | Male
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Dates
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Enumeration Date | 11/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6314 19TH ST W STE 7
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City | FIRCREST
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State | WA
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Zip | 98466-6223
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Country | US
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Telephone | 253-581-4111
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Fax | 253-581-4111
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Provider Business Mailing Address
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Address Line | 6314 19TH ST W STE 7
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City | FIRCREST
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State | WA
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Zip | 98466-6223
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Country | US
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Telephone | 253-581-4111
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Fax | 253-581-4111
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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 | AC00000174
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC2403
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License Number State | CA
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