# MAYA WHOLE HEALTH AT SOUTHPORT

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164778221
- **Authorized official:** MS. WENDY JEAN RAY (STUDIO COORDINATOR)
- **Authorized official phone:** (425) 271-0200

## Contact information

- **Practice address:** 1322 LAKE WASHINGTON BLVD N, SUITE 3, RENTON, WA 98056-0703
- **Practice address phone:** (425) 271-0200
- **Practice address fax:** (206) 309-3383
- **Mailing address:** 1322 LAKE WASHINGTON BLVD N, SUITE 3, RENTON, WA 98056-0703
- **Mailing address phone:** (425) 271-0200
- **Mailing address fax:** (206) 309-3383

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | — | NULL | Yes |
| 171100000X | Acupuncturist | — | — | Yes |
| 173C00000X | Reflexologist | — | NULL | — |
| 173C00000X | Reflexologist | — | — | — |

## Other

- **Enumeration date:** 07/26/2012
- **Last updated:** 12/28/2012