Provider Demographics
NPI:1992705776
Name:GRIFFIN, PAUL A (LAC)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:A
Last Name:GRIFFIN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:403 E MEEKER ST
Mailing Address - Street 2:STE 300
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-5904
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16315 NE 87TH ST
Practice Address - Street 2:STE B6
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3537
Practice Address - Country:US
Practice Address - Phone:425-882-1697
Practice Address - Fax:425-885-4179
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00000392171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist