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General NPI Number Information
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NPI Number | 1700420775
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Entity Type | Individual
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Provider Name | GENEVIEVE L KINNEY MACOM
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Gender | Female
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Dates
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Enumeration Date | 11/03/2019
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 340 ERICKSEN AVE NE
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City | BAINBRIDGE ISLAND
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State | WA
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Zip | 98110-1854
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Country | US
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Telephone | 206-201-9897
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Fax |
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Provider Business Mailing Address
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Address Line | 340 ERICKSEN AVE NE
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City | BAINBRIDGE ISLAND
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State | WA
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Zip | 98110-1854
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Country | US
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Telephone | 206-201-9897
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Fax |
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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 | ACUP.AC.60990154
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License Number State | WA
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