Healthcare Provider Details

I. General information

NPI: 1982876330
Provider Name (Legal Business Name): BLUME FAMILY CHIROPRACTIC & MASSAGE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2008
Last Update Date: 07/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 KRESKY AVE STE 108
CENTRALIA WA
98531-8982
US

IV. Provider business mailing address

1611 KRESKY AVE, SUITE108
CENTRALIA WA
98531-8982
US

V. Phone/Fax

Practice location:
  • Phone: 360-330-1800
  • Fax: 360-330-5866
Mailing address:
  • Phone: 360-330-1800
  • Fax: 360-330-5866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA D BLUME
Title or Position: PRESIDENT
Credential: DC
Phone: 360-330-1800