Healthcare Provider Details

I. General information

NPI: 1871672881
Provider Name (Legal Business Name): JEREMY JAMES MEADOWS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 02/18/2024
Certification Date: 02/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13325 100TH AVE NE STE D
KIRKLAND WA
98034-5213
US

IV. Provider business mailing address

13615 100TH AVE NE
KIRKLAND WA
98034-5234
US

V. Phone/Fax

Practice location:
  • Phone: 425-814-9644
  • Fax:
Mailing address:
  • Phone: 425-814-9644
  • Fax: 425-814-7395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberCH00033922
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: