# AUTUMN TA

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

## Provider details

- **NPI number:** 1780096800
- **Authorized official:** AUTUMN TA (ACUPUNCTURIST / OWNER)
- **Authorized official phone:** (206) 335-4907

## Contact information

- **Practice address:** 2366 EASTLAKE AVE E, SUITE 335, SEATTLE, WA 98102-3366
- **Practice address phone:** (206) 335-4907
- **Mailing address:** 2366 EASTLAKE AVE E, SUITE 335, SEATTLE, WA 98102-3366

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | AC60454090 | WA | Yes |

## Other

- **Enumeration date:** 05/23/2014
- **Last updated:** 05/23/2014