Healthcare Provider Details

I. General information

NPI: 1386873560
Provider Name (Legal Business Name): GREGORY PAUL COFANO D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2009
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12360 NE 8TH ST STE 200
BELLEVUE WA
98005-4801
US

IV. Provider business mailing address

12360 NE 8TH ST STE 200
BELLEVUE WA
98005-4801
US

V. Phone/Fax

Practice location:
  • Phone: 425-999-9633
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC010129
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH9778
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License NumberCH60618003
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH 60618003
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: