MEDICARE: MARIA PORTNAYA 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	AC60114166	WA

General Provider Information

NPI Number	:	1871827824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA PORTNAYA L.AC

Provider Business Mailing Address
First Line	:	1515 1ST AVE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98101-1523
Country	:	US
Telephone Number	:	206-903-1888
Fax Number	:	206-903-1893

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	:	206-903-1893

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

Provider Enumeration Date	:	09/23/2009
Last Update Date	:	09/23/2009

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Directions to “ MARIA PORTNAYA L.AC” Practice Location

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