Provider Demographics
NPI:1720814130
Name:SAMMA AJIVA ACUPUNCTURE
Entity type:Organization
Organization Name:SAMMA AJIVA ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SUGGETT
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, EAMP
Authorized Official - Phone:206-799-6892
Mailing Address - Street 1:15100 6TH AVE SW UNIT 332
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-1932
Mailing Address - Country:US
Mailing Address - Phone:206-799-6892
Mailing Address - Fax:
Practice Address - Street 1:652 SW 150TH ST
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-4612
Practice Address - Country:US
Practice Address - Phone:206-494-3360
Practice Address - Fax:206-494-3360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty