Healthcare Provider Details

I. General information

NPI: 1245436476
Provider Name (Legal Business Name): MOUNTAIN VIEW CHIRORPACTIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2007
Last Update Date: 06/06/2023
Certification Date: 06/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9812 205TH AVE E STE C
BONNEY LAKE WA
98391-8275
US

IV. Provider business mailing address

9812 205TH AVE E STE C
BONNEY LAKE WA
98391-8275
US

V. Phone/Fax

Practice location:
  • Phone: 253-863-6378
  • Fax: 253-863-6429
Mailing address:
  • Phone: 253-863-6378
  • Fax: 253-863-6429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number602561952
License Number StateWA

VIII. Authorized Official

Name: DR. JOHN HUYNH
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 253-863-6378