Healthcare Provider Details

I. General information

NPI: 1558391417
Provider Name (Legal Business Name): PIER VIEW CHIROPRACTIC, INC. PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 06/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19987 1ST AVE S STE 102
NORMANDY PARK WA
98148-2400
US

IV. Provider business mailing address

19987 1ST AVE S STE 102
NORMANDY PARK WA
98148-2400
US

V. Phone/Fax

Practice location:
  • Phone: 206-824-7200
  • Fax: 206-832-4652
Mailing address:
  • Phone: 206-824-7200
  • Fax: 206-832-4652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH00034082
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA60124192
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA60524185
License Number StateWA

VIII. Authorized Official

Name: DR. GENIE M. MARKWELL
Title or Position: CHIROPRACTIC
Credential: DC, CCWP
Phone: 206-824-7200