NPIMap

Organization Active NPI

Integrated Center for Optimum Health, LLC

  • Acupuncturist
  • Seattle, WA
National Provider Identifier
1073674388
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC00002074 Issued in WA
Legal business name
INTEGRATED CENTER FOR OPTIMUM HEALTH, LLC
Practice address
720 Olive Way Ste 900
Seattle, WA 98101-1840
Phone
(206) 623-2220
Fax
(206) 623-2228
NPI assigned
Dec 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Paul De Beijl, L.AC, PT
Title
Owner
Phone
(206) 623-2220

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X AC00002074 WA Primary
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X

Addresses

Primary practice location

720 Olive Way Ste 900
Seattle, WA 98101-1840

Mailing address

720 Olive Way Ste 900
Seattle, WA 98101-1840
Phone (206) 623-2220

Other identifiers 1

IdentifierTypeStateIssuer
162840OtherWADEPT OF LABOR & INDUSTRIE

National Provider Directory

National Provider Directory
Tax ID family
Integrated Center for Optimum Health LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

720 Olive Way
Ste 900
Seattle, WA 98101
Phone (206) 623-2220

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692230400000",
    "number": "1073674388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 OLIVE WAY STE 900",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011840",
            "telephone_number": "206-623-2220",
            "fax_number": "206-623-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 OLIVE WAY STE 900",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011840",
            "telephone_number": "206-623-2220",
            "fax_number": "206-623-2228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED CENTER FOR OPTIMUM HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A",
        "authorized_official_last_name": "DE BEIJL",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-623-2220",
        "authorized_official_credential": "L.AC, PT"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "AC00002074",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR & INDUSTRIE",
            "identifier": "162840",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.