Individual
LISE TAKASHINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC.
Contact information
Practice address
302 N 5TH ST, COEUR D ALENE, ID 83814-2814
(831) 332-0587
(831) 332-0587
Mailing address
PO BOX 1724, COEUR D ALENE, ID 83816-1724
(208) 292-4829
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
ACU-336
ID
Other
Enumeration date
07/14/2017
Last updated
06/16/2018
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