Provider Demographics
NPI:1215638218
Name:MERCER ISLAND ACUPUNCTURE & ORIENTAL MEDICINE
Entity type:Organization
Organization Name:MERCER ISLAND ACUPUNCTURE & ORIENTAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:YING
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:206-335-8856
Mailing Address - Street 1:2955 80TH AVE SE STE 108
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-2960
Mailing Address - Country:US
Mailing Address - Phone:206-335-8856
Mailing Address - Fax:206-209-2068
Practice Address - Street 1:2955 80TH AVE SE STE 108
Practice Address - Street 2:
Practice Address - City:MERCER ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98040-2960
Practice Address - Country:US
Practice Address - Phone:206-335-8856
Practice Address - Fax:206-209-2068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center