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Organization
ORIGINAL QI PLLC
Active
Organization
ORIGINAL QI PLLC
Active
Other names
Phonexay LAC
Organization subpart
No
Provider details
NPI number
Authorized official
PHONEXAY LALA SIMON EAMP, L.AC (OWNER)
(509) 554-0516
Entity
Organization
Contact information
Practice address
5401 LEARY AVE NW STE 203, SEATTLE, WA 98107-4070
(206) 582-3469
(206) 582-3472
Mailing address
5401 LEARY AVE NW STE 203, SEATTLE, WA 98107-4070
(206) 582-3469
(206) 582-3472
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC60446929
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1801209457
INDIVIDUAL NPI
—
01
—
AC60446929
STATE ACUPUNCTURE LICENSE- DOH
WA
Enumeration date
05/25/2018
Last updated
05/25/2018
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