Provider Demographics
NPI:1104477868
Name:PURIM ACUPUNCTURE & HERB CLINIC
Entity type:Organization
Organization Name:PURIM ACUPUNCTURE & HERB CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JIN
Authorized Official - Middle Name:HO
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:425-273-0023
Mailing Address - Street 1:18623 HIGHWAY 99 STE 260
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-4555
Mailing Address - Country:US
Mailing Address - Phone:425-273-0023
Mailing Address - Fax:425-491-7791
Practice Address - Street 1:18623 HIGHWAY 99 STE 260
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98037-4555
Practice Address - Country:US
Practice Address - Phone:425-273-0023
Practice Address - Fax:425-491-7791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-24
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service