Healthcare Provider Details

I. General information

NPI: 1790825198
Provider Name (Legal Business Name): VERHUNCE CHIROPRACTIC CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 01/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21904 MARINE VIEW DR S SUITE C
DES MOINES WA
98198-6103
US

IV. Provider business mailing address

21904 MARINE VIEW DR S SUITE C
DES MOINES WA
98198-6103
US

V. Phone/Fax

Practice location:
  • Phone: 206-824-5521
  • Fax: 206-212-7455
Mailing address:
  • Phone: 206-824-5521
  • Fax: 206-212-7455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number602003024
License Number StateWA

VIII. Authorized Official

Name: DR. BONNIE JEAN VERHUNCE
Title or Position: DOCTOR
Credential: D.C.
Phone: 206-824-5521