Healthcare Provider Details

I. General information

NPI: 1780548867
Provider Name (Legal Business Name): SAMUEL LYNN RUMSEY DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 W BROADWAY AVE
MOSES LAKE WA
98837-2602
US

IV. Provider business mailing address

1223 ASHLEY WAY
MOSES LAKE WA
98837-2106
US

V. Phone/Fax

Practice location:
  • Phone: 509-764-1836
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number70015113
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: