MEDICARE: COLETTE ALYSE MARIEN 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	61507890	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1659883247	OTHER	WA	GROUP NPI

General Provider Information

NPI Number	:	1649033549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLETTE ALYSE MARIEN L.AC, EAMP

Provider Business Mailing Address
First Line	:	1406 HARVARD AVE APT 16
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98122-3836
Country	:	US
Telephone Number	:	773-490-7012
Fax Number	:

Provider Business Practice Location Address
First Line	:	1515 1ST AVE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98101-1523
Country	:	US
Telephone Number	:	206-903-1888
Fax Number	:

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

Provider Enumeration Date	:	02/02/2024
Last Update Date	:	02/26/2024

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Directions to “ COLETTE ALYSE MARIEN L.AC, EAMP” Practice Location

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