Healthcare Provider Details

I. General information

NPI: 1780144006
Provider Name (Legal Business Name): JACOB PARSONS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2019
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date: 07/29/2019
Reactivation Date: 08/07/2019

III. Provider practice location address

3180 W CLEARWATER AVE STE F
KENNEWICK WA
99336-2765
US

IV. Provider business mailing address

3180 W CLEARWATER AVE STE F
KENNEWICK WA
99336-2765
US

V. Phone/Fax

Practice location:
  • Phone: 509-410-5370
  • Fax:
Mailing address:
  • Phone: 701-715-3923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number61532888
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: