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General NPI Number Information
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NPI Number | 1770791667
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Entity Type | Individual
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Provider Name | BONNIE CAREY L.AC.,O.M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 242 E STATE ST
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City | MOSSYROCK
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State | WA
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Zip | 98564
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Country | US
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Telephone | 360-983-8594
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Fax |
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Provider Business Mailing Address
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Address Line | 146 MCDOUGALL RD W
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City | MOSSYROCK
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State | WA
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Zip | 98564-9416
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Country | US
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Telephone | 360-983-8594
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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 | 622
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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 | 10
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License Number State | CT
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