Provider Demographics
NPI:1285087502
Name:ESKANDARI, NICOLE SEPIEDEH (MS LAC)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:SEPIEDEH
Last Name:ESKANDARI
Suffix:
Gender:F
Credentials:MS LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2711 14TH AVE S
Mailing Address - Street 2:A
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-5098
Mailing Address - Country:US
Mailing Address - Phone:602-369-4667
Mailing Address - Fax:
Practice Address - Street 1:2711 14TH AVE S
Practice Address - Street 2:A
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-5098
Practice Address - Country:US
Practice Address - Phone:602-369-4667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-21
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60653216171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist