Provider Demographics
NPI:1962870667
Name:MEDICAL MASSAGE & ACUPUNCTURE, P.S.
Entity type:Organization
Organization Name:MEDICAL MASSAGE & ACUPUNCTURE, P.S.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:KUHLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:360-996-4778
Mailing Address - Street 1:2980 N BEVERLY GLEN CIR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-1726
Mailing Address - Country:US
Mailing Address - Phone:310-943-4180
Mailing Address - Fax:
Practice Address - Street 1:2530 NE KRESKY AVE
Practice Address - Street 2:SUITE B
Practice Address - City:CHEHALIS
Practice Address - State:WA
Practice Address - Zip Code:98532-2406
Practice Address - Country:US
Practice Address - Phone:360-996-4778
Practice Address - Fax:360-996-4783
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDICAL MASSAGE & ACUPUNCTURE, P.S.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-09-11
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00000843332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site