Provider Demographics
NPI:1699082156
Name:BOISSEAU, NATALIE-PASCALE A (LAC, LMP)
Entity type:Individual
Prefix:
First Name:NATALIE-PASCALE
Middle Name:A
Last Name:BOISSEAU
Suffix:
Gender:F
Credentials:LAC, LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 5TH AVE S
Mailing Address - Street 2:SUITE 103
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98020-3464
Mailing Address - Country:US
Mailing Address - Phone:206-915-6868
Mailing Address - Fax:
Practice Address - Street 1:420 5TH AVE S
Practice Address - Street 2:SUITE 103
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98020-3464
Practice Address - Country:US
Practice Address - Phone:206-915-6868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-04
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60175366171100000X
WAMA 00022731225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist