Provider Demographics
NPI:1770240913
Name:BARNES, ADAM (LAC)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:BARNES
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 10TH AVE SE APT 6
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-1351
Mailing Address - Country:US
Mailing Address - Phone:253-273-2407
Mailing Address - Fax:
Practice Address - Street 1:317 4TH AVE E STE 206
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-1134
Practice Address - Country:US
Practice Address - Phone:253-273-2407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-23
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60762866171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist