Healthcare Provider Details

I. General information

NPI: 1093984486
Provider Name (Legal Business Name): OLYMPIC VIEW CHIROPRACTIC, PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/29/2008
Last Update Date: 03/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

626 128TH ST SW SUITE 103B
EVERETT WA
98204-6368
US

IV. Provider business mailing address

626 128TH ST SW SUITE 103B
EVERETT WA
98204-6368
US

V. Phone/Fax

Practice location:
  • Phone: 425-513-1880
  • Fax: 425-513-6161
Mailing address:
  • Phone: 425-513-1880
  • Fax: 425-513-6161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number601822073
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA00025054
License Number StateWA

VIII. Authorized Official

Name: DR. GREGORY C. ZOGRAFOS
Title or Position: OWNER/CHIROPRACTOR
Credential: DC
Phone: 425-513-1880