Healthcare Provider Details

I. General information

NPI: 1912144452
Provider Name (Legal Business Name): SCOTT KEVIN PACHECO D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2009
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1218 SW SCOTTON WAY STE 102-104
BATTLE GROUND WA
98604-2718
US

IV. Provider business mailing address

PO BOX 3412
ARLINGTON WA
98223-3412
US

V. Phone/Fax

Practice location:
  • Phone: 360-667-5192
  • Fax:
Mailing address:
  • Phone: 510-501-5774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number30644
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH60927781
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: