Experience Acupunture, Inc

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC563 Issued in WA

Legal business name

EXPERIENCE ACUPUNTURE, INC

Practice address

821 E Thomas St
Seattle, WA 98102-5478

Phone

(206) 719-5042

NPI assigned

Dec 27, 2006

Organization subpart

No

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

Authorized official

Name

Astrid E Sidler-Dever, L.AC

Title

President

Phone

(206) 719-5042

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093870008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 31ST AVE E",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981124824",
            "telephone_number": "206-719-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 E THOMAS ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981025478",
            "telephone_number": "206-719-5042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPERIENCE ACUPUNTURE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SIDLER-DEVER",
        "authorized_official_first_name": "ASTRID",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "206-719-5042",
        "authorized_official_credential": "L.AC"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "AC563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.