Healthcare Provider Details

I. General information

NPI: 1922211663
Provider Name (Legal Business Name): BEDLINGTON CHIROPRACTIC CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 10/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 E MAIN ST
EVERSON WA
98247-0160
US

IV. Provider business mailing address

PO BOX 160 211 E MAIN ST
EVERSON WA
98247-0160
US

V. Phone/Fax

Practice location:
  • Phone: 360-966-5844
  • Fax: 360-966-7718
Mailing address:
  • Phone: 360-966-5844
  • Fax: 360-966-7718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH00002655
License Number StateWA

VIII. Authorized Official

Name: MR. RAYMOND ALDEN BEDLINGTON
Title or Position: CEO DOCTOR
Credential: DC
Phone: 360-966-5844