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General NPI Number Information
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NPI Number | 1902574627
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Entity Type | Individual
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Provider Name | GIANNA PRILL LAC
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Gender | Female
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Dates
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Enumeration Date | 08/30/2021
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Last Update Date | 08/30/2021
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Provider Practice Location Address
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Address Line | 1803 STATE AVE NE
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City | OLYMPIA
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State | WA
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Zip | 98506-4649
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Country | US
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Telephone | 360-943-6730
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1084
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City | OLYMPIA
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State | WA
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Zip | 98507-1084
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Country | US
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Telephone | 360-943-6730
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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 | AC60040885
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License Number State | WA
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