MEDICARE: SEWARD PARK THERAPEUTICS

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	LAC488	WA
2	225700000X	Massage Therapist	MA00023864	WA

General Provider Information

NPI Number	:	1194022426
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEWARD PARK THERAPEUTICS

Provider Business Mailing Address
First Line	:	8435 S 114TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98178-3321
Country	:	US
Telephone Number	:	206-772-0898
Fax Number	:	206-508-4136

Provider Business Practice Location Address
First Line	:	8435 S 114TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98178-3321
Country	:	US
Telephone Number	:	206-772-0898
Fax Number	:	206-508-4136

Authorized Official
Title or Position	:	OWNER
Name	:	DANA KIRKWOOD-WATTS
Credential	:
Telephone Number	:	206-772-0898

Provider Enumeration Date	:	02/23/2011
Last Update Date	:	02/23/2011

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