MEDICARE: CYNTHIA MARIE SOTO L. AC, EAMP

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	AC60227110	WA

General Provider Information

NPI Number	:	1083965644
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA MARIE SOTO L. AC, EAMP

Provider Business Mailing Address
First Line	:	3418 NE 65TH ST
Second Line	:	#206
City	:	SEATTLE
State	:	WA
Zip	:	98115-7350
Country	:	US
Telephone Number	:	206-407-8002
Fax Number	:

Provider Business Practice Location Address
First Line	:	3418 NE 65TH ST
Second Line	:	#206
City	:	SEATTLE
State	:	WA
Zip	:	98115-7350
Country	:	US
Telephone Number	:	206-407-8002
Fax Number	:

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

Provider Enumeration Date	:	09/24/2012
Last Update Date	:	09/24/2012

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