Provider Demographics
NPI:1598022741
Name:BAILEY, ROSELYN THU (LAC)
Entity type:Individual
Prefix:MRS
First Name:ROSELYN
Middle Name:THU
Last Name:BAILEY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11611 AIRPORT RD
Mailing Address - Street 2:SUITE 105C
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-3782
Mailing Address - Country:US
Mailing Address - Phone:425-789-8996
Mailing Address - Fax:
Practice Address - Street 1:11611 AIRPORT RD
Practice Address - Street 2:SUITE 105C
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-3782
Practice Address - Country:US
Practice Address - Phone:425-789-8996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-12
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60261294171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist