NPIMap

Organization Active NPI

Heavenly Ancestor 5 Element Acupuncture LLC

Doing business as 5 Element Acupuncture

  • Acupuncturist
  • Bainbridge Island, WA
National Provider Identifier
1114387560
Registry record updated Mar 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC 60354712 Issued in WA
Legal business name
HEAVENLY ANCESTOR 5 ELEMENT ACUPUNCTURE LLC
Doing business as
5 Element Acupuncture
Practice address
7701 Westerly LN NE
Bainbridge Island, WA 98110-2698
Phone
(206) 245-6119
NPI assigned
Feb 27, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2016

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

Authorized official

Name
Ms. Kirsten Marie Thomassen, EAMP, L.AC., DIPL.ACNPI 1487002713
Title
Acupuncturist
Phone
(206) 245-6119

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 171100000X AC 60354712 WA Primary
AcupuncturistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 171100000X 5401000102 MI

Addresses

Primary practice location

7701 Westerly LN NE
Bainbridge Island, WA 98110-2698

Mailing address

7701 Westerly LN NE
Bainbridge Island, WA 98110-2698
Phone (206) 245-6119

Other names 1

  • 5 Element Acupuncture Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1456531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456790400000",
    "number": "1114387560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7701 WESTERLY LN NE",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981102698",
            "telephone_number": "206-245-6119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7701 WESTERLY LN NE",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981102698",
            "telephone_number": "206-245-6119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVENLY ANCESTOR 5 ELEMENT ACUPUNCTURE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-27",
        "last_updated": "2016-03-01",
        "status": "A",
        "authorized_official_last_name": "THOMASSEN",
        "authorized_official_first_name": "KIRSTEN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "ACUPUNCTURIST",
        "authorized_official_telephone_number": "206-245-6119",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "EAMP, L.AC., DIPL.AC"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "AC 60354712",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "MI",
            "license": "5401000102",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "5 Element Acupuncture",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bainbridge Island, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2016; 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.