MEDICARE: DR. XING DONG MA O.M.D, L.A.C

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	AC00000614	WA

General Provider Information

NPI Number	:	1912071721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. XING DONG MA O.M.D, L.A.C

Provider Business Mailing Address
First Line	:	326 QUEEN ANNE AVE NORTH #C-101
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98109
Country	:	US
Telephone Number	:	206-363-8160
Fax Number	:	206-284-7199

Provider Business Practice Location Address
First Line	:	326 QUEEN ANNE AVE N # C-101
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98109-4558
Country	:	US
Telephone Number	:	206-363-8160
Fax Number	:	206-284-7199

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

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	07/08/2007

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