Healthcare Provider Details

I. General information

NPI: 1295480069
Provider Name (Legal Business Name): TORRES CHIROPRACTIC MEDICAL CENTER, PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2022
Last Update Date: 02/19/2022
Certification Date: 02/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11210 BRIDGEPORT WAY SW
LAKEWOOD WA
98499-3003
US

IV. Provider business mailing address

4004 NE 4TH ST STE 107-209
RENTON WA
98056-4102
US

V. Phone/Fax

Practice location:
  • Phone: 253-503-0443
  • Fax: 253-449-0510
Mailing address:
  • Phone: 253-579-6105
  • Fax: 253-449-0510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. GABRIEL TORRES
Title or Position: PRESIDENT
Credential: DC
Phone: 253-579-6105