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General NPI Number Information
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NPI Number | 1912071721
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Entity Type | Individual
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Provider Name | XING DONG MA O.M.D, L.A.C
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Gender | Female
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 326 QUEEN ANNE AVE N # C-101
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City | SEATTLE
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State | WA
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Zip | 98109-4558
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Country | US
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Telephone | 206-363-8160
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Fax | 206-284-7199
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Provider Business Mailing Address
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Address Line | 326 QUEEN ANNE AVE NORTH #C-101
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City | SEATTLE
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State | WA
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Zip | 98109
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Country | US
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Telephone | 206-363-8160
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Fax | 206-284-7199
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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 | AC00000614
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License Number State | WA
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