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Organization
ELEVATED ACUPUNCTURE LLC
Active
Organization
ELEVATED ACUPUNCTURE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETHANY C DEMARCO LAC, MSAOM, RN (CEO)
(303) 378-0557
Entity
Organization
Contact information
Practice address
1500 FAIRVIEW AVE E STE 205, SEATTLE, WA 98102-3727
(253) 987-6049
(206) 325-9292
Mailing address
9810 42ND AVE SW, SEATTLE, WA 98136-2819
(303) 378-0557
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
—
NULL
171100000X
Acupuncturist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002552
CO STATE ACUPUNCTURE LICENSE
CO
01
—
1588202782
INDIVIDUAL NPI
—
01
—
AC61079087
WA STATE ACUPUNCTURE LICENSE
WA
01
—
NCC84637
NCCAOM BOARD CERTIFICATION
—
Enumeration date
04/27/2022
Last updated
04/27/2022
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