MEDICARE: NATURALLY CHIROPRACTIC FAMILY WELLNESS CENTER INC

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	602146175	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538369095
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATURALLY CHIROPRACTIC FAMILY WELLNESS CENTER INC

Provider Business Mailing Address
First Line	:	9327 4TH ST NE
Second Line	:	SUITE 6
City	:	LAKE STEVENS
State	:	WA
Zip	:	98258-1630
Country	:	US
Telephone Number	:	425-334-6258
Fax Number	:	425-334-1187

Provider Business Practice Location Address
First Line	:	9327 4TH ST NE
Second Line	:	SUITE 6
City	:	LAKE STEVENS
State	:	WA
Zip	:	98258-1630
Country	:	US
Telephone Number	:	425-334-6258
Fax Number	:	425-334-1187

Authorized Official
Title or Position	:	DR./ OWNER
Name	:	DR. NICOLE ALLISON MORIN
Credential	:	D.C.
Telephone Number	:	425-334-6258

Provider Enumeration Date	:	07/23/2007
Last Update Date	:	11/10/2016

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