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General NPI Number Information
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NPI Number | 1720402670
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Entity Type | Individual
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Provider Name | CAITLIN MAYOTTE L.AC., EAMP
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Gender | Female
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Dates
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Enumeration Date | 02/13/2014
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Last Update Date | 02/13/2014
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Provider Practice Location Address
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Address Line | 15003 75TH AVE NE
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City | KENMORE
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State | WA
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Zip | 98028-4649
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Country | US
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Telephone | 734-646-6884
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Fax |
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Provider Business Mailing Address
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Address Line | 15003 75TH AVE NE
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City | KENMORE
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State | WA
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Zip | 98028-4649
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Country | US
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Telephone | 734-646-6884
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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 | AC 60440491
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License Number State | WA
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