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General NPI Number Information
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NPI Number | 1871953547
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Entity Type | Individual
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Provider Name | YULIANI CHANDRANATA LAC, MSAOM, EAMP, ND
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Gender | Female
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Dates
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Enumeration Date | 02/24/2016
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Last Update Date | 09/22/2016
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Provider Practice Location Address
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Address Line | 4301 STONE WAY N, SUITE 211
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City | SEATTLE
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State | WA
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Zip | 98103
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Country | US
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Telephone | 909-859-9952
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Fax |
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Provider Business Mailing Address
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Address Line | D' NATURAL SURABAYA JL. DR. SOETOMO NO. 75
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City | SURABAYA
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State | JAWA TIMUR (EAST JAVA)
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Zip | 60264
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Country | ID
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Telephone | 19098599952
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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 | AC60623797
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License Number State | WA
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