Provider Demographics
NPI:1306140322
Name:SCOFIELD, ANNA C (LAC, DIPLOM)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:C
Last Name:SCOFIELD
Suffix:
Gender:F
Credentials:LAC, DIPLOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 VILLAGE WAY
Mailing Address - Street 2:
Mailing Address - City:PORT LUDLOW
Mailing Address - State:WA
Mailing Address - Zip Code:98365-9762
Mailing Address - Country:US
Mailing Address - Phone:360-437-3798
Mailing Address - Fax:
Practice Address - Street 1:91 VILLAGE WAY
Practice Address - Street 2:
Practice Address - City:PORT LUDLOW
Practice Address - State:WA
Practice Address - Zip Code:98365-9762
Practice Address - Country:US
Practice Address - Phone:360-437-3798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-05
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1629171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist