Healthcare Provider Details

I. General information

NPI: 1801452412
Provider Name (Legal Business Name): DYNAMIC CHIROS OF AUBURN PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2019
Last Update Date: 11/12/2020
Certification Date: 11/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3820 S 320TH ST
AUBURN WA
98001-3115
US

IV. Provider business mailing address

3820 S 320TH ST
AUBURN WA
98001-3115
US

V. Phone/Fax

Practice location:
  • Phone: 253-839-2650
  • Fax: 253-839-4528
Mailing address:
  • Phone: 253-839-2650
  • Fax: 253-839-4528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. MARK THOMPSON
Title or Position: OWNER
Credential: DC
Phone: 253-839-2650