Healthcare Provider Details

I. General information

NPI: 1104825686
Provider Name (Legal Business Name): LOREN CARY ERNST DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 11/10/2010
Certification Date:
Deactivation Date: 03/18/2006
Reactivation Date: 03/30/2007

III. Provider practice location address

16714 SMOKEY POINT BLVD
ARLINGTON WA
98223
US

IV. Provider business mailing address

16714 SMOKEY POINT BLVD
ARLINGTON WA
98223
US

V. Phone/Fax

Practice location:
  • Phone: 360-659-8464
  • Fax: 360-659-3044
Mailing address:
  • Phone: 360-659-8464
  • Fax: 360-659-3044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2486
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: