Healthcare Provider Details

I. General information

NPI: 1235311895
Provider Name (Legal Business Name): ESSENTIAL CHIROPRACTIC AND ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2007
Last Update Date: 04/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 140TH AVE NE SUITE D
BELLEVUE WA
98005-2972
US

IV. Provider business mailing address

1050 140TH AVE NE SUITE D
BELLEVUE WA
98005-2972
US

V. Phone/Fax

Practice location:
  • Phone: 425-688-0223
  • Fax: 425-688-0323
Mailing address:
  • Phone: 425-688-0223
  • Fax: 425-688-0323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number33822
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. SCOTT HAMMONS
Title or Position: PRESIDENT
Credential: D.C.
Phone: 425-688-0223