# ORIGINAL QI PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Phonexay LAC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528559416
- **Authorized official:** PHONEXAY LALA SIMON EAMP, L.AC (OWNER)
- **Authorized official phone:** (509) 554-0516

## Contact information

- **Practice address:** 5401 LEARY AVE NW STE 203, SEATTLE, WA 98107-4070
- **Practice address phone:** (206) 582-3469
- **Practice address fax:** (206) 582-3472
- **Mailing address:** 5401 LEARY AVE NW STE 203, SEATTLE, WA 98107-4070
- **Mailing address phone:** (206) 582-3469
- **Mailing address fax:** (206) 582-3472

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | AC60446929 | WA | Yes |

## Other

- **Enumeration date:** 05/25/2018
- **Last updated:** 05/25/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1801209457 | INDIVIDUAL NPI | — |
| 01 | — | AC60446929 | STATE ACUPUNCTURE LICENSE- DOH | WA |