5e Community Clinic, LLC

NPI #1457779738 in Seattle, Washington

Provider Information

NPI Number: 1457779738
Entity Type: Organization
Organization Name: 5e Community Clinic, LLC
Primary Specialty: Acupuncturist
Enumeration Date: Apr 3, 2014
Last Updated: Apr 3, 2014

Practice Location

Address: 5424 BALLARD AVE NW
Address 2: SUITE 301
City: Seattle
State: Washington
ZIP Code: 98107-4046
Phone: (206) 781-1371

Authorized Official

Name: MARK R TIBEAU, EAMP, L.AC
Title: SOLE MEMBER
Phone: (206) 781-1371

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Acupuncturist	171100000X	Primary

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