Healthcare Provider Details

I. General information

NPI: 1023139680
Provider Name (Legal Business Name): PAUL B BYERS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 02/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9003 CANYON DR
KENT WA
98030-4779
US

IV. Provider business mailing address

9003 CANYON DR
KENT WA
98030-4779
US

V. Phone/Fax

Practice location:
  • Phone: 253-852-1250
  • Fax: 253-373-0301
Mailing address:
  • Phone: 253-852-1250
  • Fax: 253-373-0301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberCH00003283
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: