MEDICARE: DR. DAVID LLOYD GRIFFITH D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2288	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	R70095	OTHER	WA	REGENCE RIDER NUMBER
2	06913	OTHER	WA	WA STATE L&I

General Provider Information

NPI Number	:	1306960521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID LLOYD GRIFFITH D.C.

Provider Business Mailing Address
First Line	:	PO BOX 147
Second Line	:
City	:	MARYSVILLE
State	:	WA
Zip	:	98270-0147
Country	:	US
Telephone Number	:	425-750-0959
Fax Number	:

Provider Business Practice Location Address
First Line	:	505 CEDAR AVE STE C
Second Line	:
City	:	MARYSVILLE
State	:	WA
Zip	:	98270-4561
Country	:	US
Telephone Number	:	425-750-0959
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2007
Last Update Date	:	07/08/2007

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