=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942751870
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HO YONG LIM EAMP, LAC, HERBALIST
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/14/2016
-----------------------------------------------------
Last Update Date | 01/03/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 34503 9TH AVE S STE 320
-----------------------------------------------------
City | FEDERAL WAY
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98003-8726
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 253-632-0555
-----------------------------------------------------
Fax | 253-944-4074
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7137 MONTEVISTA DR SE
-----------------------------------------------------
City | AUBURN
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98092-8224
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 253-632-0555
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | AC60695229
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------