Healthcare Provider Details

I. General information

NPI: 1376266866
Provider Name (Legal Business Name): LINK CHIROPRACTIC AND WELLNESS PS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2022
Last Update Date: 09/21/2022
Certification Date: 09/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25854 108TH AVE SE
KENT WA
98030-7737
US

IV. Provider business mailing address

25854 108TH AVE SE
KENT WA
98030-7737
US

V. Phone/Fax

Practice location:
  • Phone: 253-852-2828
  • Fax: 253-852-2830
Mailing address:
  • Phone: 253-852-2828
  • Fax: 253-852-2830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. NAZARIY STETSYUK
Title or Position: DOCTOR OF CHIROPRACTIC
Credential: DC
Phone: 253-852-2828