Healthcare Provider Details

I. General information

NPI: 1902965916
Provider Name (Legal Business Name): CRAIG WEINER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 03/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2812 BAYVIEW RD
LANGLEY WA
98260
US

IV. Provider business mailing address

PO BOX 1258
FREELAND WA
98249
US

V. Phone/Fax

Practice location:
  • Phone: 360-331-5565
  • Fax: 360-331-7122
Mailing address:
  • Phone: 360-331-5565
  • Fax: 360-331-7122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH00033715
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: