MEDICARE: CHARLYNE LOUISE COKE N.D., 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	AC00002951	WA
2	175F00000X	Naturopath	NT00001496	WA

General Provider Information

NPI Number	:	1699061366
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLYNE LOUISE COKE N.D., L.AC.

Provider Business Mailing Address
First Line	:	21443 99TH AVE S
Second Line	:
City	:	KENT
State	:	WA
Zip	:	98031-2004
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	21443 99TH AVE S
Second Line	:
City	:	KENT
State	:	WA
Zip	:	98031-2004
Country	:	US
Telephone Number	:	206-355-5397
Fax Number	:

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

Provider Enumeration Date	:	06/21/2011
Last Update Date	:	06/21/2011

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Directions to “ CHARLYNE LOUISE COKE N.D., L.AC.” Practice Location

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