# LAKE FOREST PARK ACUPUNCTURE AND MASSAGE

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

## Provider details

- **NPI number:** 1306208830
- **Authorized official:** KIERAN MCMANIMON LMP (OWNER/PARTNER/MASSAGE THERAPIST)
- **Authorized official phone:** (206) 962-7620

## Contact information

- **Practice address:** 18724 35TH AVE NE, LAKE FOREST PARK, WA 98155-2602
- **Practice address phone:** (206) 962-7620
- **Mailing address:** 18724 35TH AVE NE, LAKE FOREST PARK, WA 98155-2602
- **Mailing address phone:** (206) 962-7620

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | AC60525308 | WA | Yes |
| 225700000X | Massage Therapist | MA60228942 | WA | — |

## Other

- **Enumeration date:** 03/23/2016
- **Last updated:** 03/23/2016