MEDICARE: TERI APPLEGATE L.AC.

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	AC00002610	WA

General Provider Information

NPI Number	:	1295925766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERI APPLEGATE L.AC.

Provider Business Mailing Address
First Line	:	PO BOX 17724
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98127-1300
Country	:	US
Telephone Number	:	206-778-9907
Fax Number	:	206-784-0228

Provider Business Practice Location Address
First Line	:	8122 GREEN LAKE DR N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-4412
Country	:	US
Telephone Number	:	206-778-9907
Fax Number	:	206-784-0228

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

Provider Enumeration Date	:	07/30/2007
Last Update Date	:	07/30/2007

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Directions to “ TERI APPLEGATE L.AC.” Practice Location

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