NPIMap

Individual provider Active NPI

Mykol Radziszewski, L.AC., EAMP

  • Acupuncturist
  • Seattle, WA
National Provider Identifier
1134410483
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC 60182088 Issued in WA
Practice address
6715 Greenwood Ave N
Seattle, WA 98103-5225
Phone
(206) 251-7109
NPI assigned
Apr 20, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC 60182088 WA Primary

Addresses

Primary practice location

6715 Greenwood Ave N
Seattle, WA 98103-5225

Mailing address

6715 Greenwood Ave N
Seattle, WA 98103-5225
Phone (206) 251-7109

Other names 1

  • Michael Radziszewski Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AC 60182088WAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
White Willow Road Healing Center, LLC Acupuncturist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1303257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348704000000",
    "number": "1134410483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6715 GREENWOOD AVE N",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981035225",
            "telephone_number": "206-251-7109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6715 GREENWOOD AVE N",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981035225",
            "telephone_number": "206-251-7109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADZISZEWSKI",
        "first_name": "MYKOL",
        "credential": "L.AC., EAMP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-20",
        "last_updated": "2012-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "AC 60182088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "RADZISZEWSKI",
            "credential": "L.AC., EAMP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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 Sep 27, 2012; 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.