Healthcare Provider Details

I. General information

NPI: 1003737735
Provider Name (Legal Business Name): PACIFIC NORTHWEST CHIRO PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 S 305TH PL STE B
FEDERAL WAY WA
98003-4804
US

IV. Provider business mailing address

1700 S 305TH PL STE B
FEDERAL WAY WA
98003-4804
US

V. Phone/Fax

Practice location:
  • Phone: 253-563-4300
  • Fax:
Mailing address:
  • Phone: 253-563-4300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: HUXLEY RIAN CROSS
Title or Position: OWNER
Credential: DC
Phone: 253-985-0018