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General NPI Number Information
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NPI Number | 1861233934
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Entity Type | Organization
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Legal Business Name | EDGEWOOD ACUPUNCTURE
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 3217 MERIDIAN AVE E
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City | EDGEWOOD
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State | WA
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Zip | 98371-2613
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Country | US
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Telephone | 253-927-5905
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Fax | 253-321-0219
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Provider Business Mailing Address
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Address Line | 3217 MERIDIAN AVE E
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City | EDGEWOOD
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State | WA
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Zip | 98371-2613
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Country | US
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Telephone | 253-927-5905
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Fax | 253-321-0219
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Authorized Official
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Title or Position | OWNER
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Name | MS. AUBREY J WHITTIER
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Credential | MSOM, LAC
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Telephone | 253-927-5905
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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 |
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License Number State |
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