MEDICARE: REBECCA STOTT LAC

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	AC60338512	WA
2	171100000X	Acupuncturist	091.0045903	VT

General Provider Information

NPI Number	:	1700207719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA STOTT LAC

Provider Business Mailing Address
First Line	:	1518 1ST AVE W
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98119-3003
Country	:	US
Telephone Number	:	802-258-7798
Fax Number	:

Provider Business Practice Location Address
First Line	:	1523 E MADISON ST
Second Line	:	RM 7
City	:	SEATTLE
State	:	WA
Zip	:	98122-4013
Country	:	US
Telephone Number	:	802-258-7798
Fax Number	:

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

Provider Enumeration Date	:	12/17/2013
Last Update Date	:	12/17/2013

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Directions to “ REBECCA STOTT LAC” Practice Location

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