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Individual

AUTUMN TA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
EAMP

Contact information

Practice address
6869 WOODLAWN AVE NE, SUITE 208, SEATTLE, WA 98115-5469
(206) 535-8867
Mailing address
637 141ST CT SE, APT F106, BELLEVUE, WA 98007-6757
(206) 335-4907

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC60454090
WA

Other

Enumeration date
08/21/2015
Last updated
08/21/2015
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