MEDICARE: WHITE CENTER CHIROPRACTIC, PLLC

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	CH34448	WA

General Provider Information

NPI Number	:	1780693085
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHITE CENTER CHIROPRACTIC, PLLC

Provider Business Mailing Address
First Line	:	10030 15TH AVE SW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98146-3728
Country	:	US
Telephone Number	:	206-763-7464
Fax Number	:

Provider Business Practice Location Address
First Line	:	10030 15TH AVE SW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98146-3728
Country	:	US
Telephone Number	:	206-763-7464
Fax Number	:

Authorized Official
Title or Position	:	MANAGER/MEMBER
Name	:	DR. IAN DAVIS
Credential	:	D.C.
Telephone Number	:	206-763-7464

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	03/06/2008

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