Healthcare Provider Details

I. General information

NPI: 1306429725
Provider Name (Legal Business Name): TOWERS FAMILY CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2021
Last Update Date: 06/28/2021
Certification Date: 06/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23515 NE NOVELTY HILL RD STE B225
REDMOND WA
98053-2073
US

IV. Provider business mailing address

23515 NE NOVELTY HILL RD STE B225
REDMOND WA
98053-2073
US

V. Phone/Fax

Practice location:
  • Phone: 425-898-8000
  • Fax: 425-898-8005
Mailing address:
  • Phone: 425-898-8000
  • Fax: 425-898-8005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW GOLDEN LARSON
Title or Position: PRESIDENT
Credential: DC
Phone: 425-898-3055