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General NPI Number Information
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NPI Number | 1689848335
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Entity Type | Organization
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Legal Business Name | MIDDLE PATH ACUPUNCTURE & ORIENTAL MEDICINE
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Dates
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Enumeration Date | 04/14/2008
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Last Update Date | 06/17/2014
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Provider Practice Location Address
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Address Line | 502 N ANDERSON ST
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City | ELLENSBURG
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State | WA
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Zip | 98926-3147
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Country | US
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Telephone | 509-925-1530
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Fax | 509-925-1526
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Provider Business Mailing Address
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Address Line | 502 N ANDERSON ST
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City | ELLENSBURG
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State | WA
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Zip | 98926-3147
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Country | US
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Telephone | 509-925-1530
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Fax | 509-925-1526
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Authorized Official
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Title or Position | OWNER
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Name | MR. JEFFREY SPRAGUE LIPPINCOTT
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Credential | LAC.
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Telephone | 509-925-1530
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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 | AC 00002972
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License Number State | WA
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