Provider Demographics
NPI:1124469226
Name:AMBROSIA HEALING ARTS, INC.
Entity type:Organization
Organization Name:AMBROSIA HEALING ARTS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:EMRYS
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, EAMP
Authorized Official - Phone:828-680-9524
Mailing Address - Street 1:1519 9TH ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-4600
Mailing Address - Country:US
Mailing Address - Phone:360-653-2526
Mailing Address - Fax:360-363-6699
Practice Address - Street 1:1519 9TH ST
Practice Address - Street 2:SUITE 103
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-4600
Practice Address - Country:US
Practice Address - Phone:360-653-2526
Practice Address - Fax:360-363-6699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC 60343617171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty