Healthcare Provider Details

I. General information

NPI: 1093046765
Provider Name (Legal Business Name): BENJAMIN GEORGE MCCAY DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2010
Last Update Date: 01/25/2025
Certification Date: 01/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9212 EVERGREEN WAY
EVERETT WA
98204-7125
US

IV. Provider business mailing address

9212 EVERGREEN WAY
EVERETT WA
98204-7125
US

V. Phone/Fax

Practice location:
  • Phone: 425-353-7246
  • Fax: 425-267-0961
Mailing address:
  • Phone: 425-353-7246
  • Fax: 425-267-0961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH60115750
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: