Andrew Ebalo, MSAOM, E.A.M.P.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC00002441 Issued in WA

Practice address

1611 116TH Ave NE
Suite 101
Bellevue, WA 98004-3048

Phone

(206) 898-1204

NPI assigned

Nov 28, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472515200000",
    "number": "1629250022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1221",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980411221",
            "telephone_number": "206-898-1204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 116TH AVE NE",
            "address_2": "SUITE 101",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043048",
            "telephone_number": "206-898-1204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBALO",
        "first_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "MSAOM, E.A.M.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-28",
        "last_updated": "2016-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "AC00002441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Acupuncturist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Acupuncturist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.