MEDICARE: MS. ANDREA M IWIULA LAC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	AC00000474	WA

General Provider Information

NPI Number	:	1053454397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANDREA M IWIULA LAC.

Provider Business Mailing Address
First Line	:	2208 NW MARKET ST STE 410
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98107-4097
Country	:	US
Telephone Number	:	206-860-1704
Fax Number	:	206-526-5262

Provider Business Practice Location Address
First Line	:	2208 NW MARKET ST STE 410
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98107-4097
Country	:	US
Telephone Number	:	206-860-1704
Fax Number	:	206-526-5262

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	04/06/2026

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