Healthcare Provider Details

I. General information

NPI: 1922255850
Provider Name (Legal Business Name): EW HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2008
Last Update Date: 02/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3202 E GREENWAY RD SUITE 1619
PHOENIX AZ
85032-4548
US

IV. Provider business mailing address

3202 E GREENWAY RD SUITE 1619
PHOENIX AZ
85032-4548
US

V. Phone/Fax

Practice location:
  • Phone: 602-482-2282
  • Fax:
Mailing address:
  • Phone: 602-482-2282
  • Fax: 602-889-5834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number005799
License Number StateAZ
# 4
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7926
License Number StateAZ

VIII. Authorized Official

Name: ERIN LEE WAYCHOFF
Title or Position: PRESIDENT
Credential: DC
Phone: 602-482-2282