Organization
ORIGINAL QI PLLC
Active
Other names
Phonexay LAC
Organization subpart
No
Provider details
NPI number
Authorized official
PHONEXAY LALA SIMON EAMP, L.AC (OWNER)
(509) 554-0516
Entity
Organization
Contact information
Practice address
5401 LEARY AVE NW STE 203, SEATTLE, WA 98107-4070
(206) 582-3469
(206) 582-3472
Mailing address
5401 LEARY AVE NW STE 203, SEATTLE, WA 98107-4070
(206) 582-3469
(206) 582-3472
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC60446929
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1801209457
INDIVIDUAL NPI
—
01
—
AC60446929
STATE ACUPUNCTURE LICENSE- DOH
WA
Enumeration date
05/25/2018
Last updated
05/25/2018
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