# SACRED ROOT ACUPUNCTURE & NATUROPATHIC MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sacred Root Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760755425
- **Authorized official:** JOSHUA L GREEN LAC, (CO-OWNER, PRACTITIONER)
- **Authorized official phone:** (425) 256-7798

## Contact information

- **Practice address:** 611 MAIN ST, SUITE A, EDMONDS, WA 98020-3096
- **Practice address phone:** (425) 229-1070
- **Mailing address:** 611 MAIN ST, SUITE A, EDMONDS, WA 98020-3096
- **Mailing address phone:** (425) 256-7798
- **Mailing address fax:** (425) 274-3409

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | 60244418 | WA | Yes |
| 175F00000X | Naturopath | 60515973 | WA | — |
| 261Q00000X | Clinic/Center | \#AC60244418 | WA | — |
| 261Q00000X | Clinic/Center | AC155797 | OR | — |

## Other

- **Enumeration date:** 02/10/2012
- **Last updated:** 08/03/2016