# HEAVENLY ANCESTOR 5 ELEMENT ACUPUNCTURE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** 5 Element Acupuncture
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114387560
- **Authorized official:** MS. KIRSTEN MARIE THOMASSEN EAMP, L.AC., DIPL.AC (ACUPUNCTURIST)
- **Authorized official phone:** (206) 245-6119

## Contact information

- **Practice address:** 7701 WESTERLY LN NE, BAINBRIDGE ISLAND, WA 98110-2698
- **Practice address phone:** (206) 245-6119
- **Mailing address:** 7701 WESTERLY LN NE, BAINBRIDGE ISLAND, WA 98110-2698
- **Mailing address phone:** (206) 245-6119

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | 5401000102 | MI | — |
| 171100000X | Acupuncturist | AC 60354712 | WA | Yes |

## Other

- **Enumeration date:** 02/27/2016
- **Last updated:** 03/01/2016