Healthcare Provider Details

I. General information

NPI: 1558607127
Provider Name (Legal Business Name): 8TH AVE CHIROPRACTIC AND MASSAGE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2012
Last Update Date: 05/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6204 8TH AVE NW
SEATTLE WA
98107-2270
US

IV. Provider business mailing address

6204 8TH AVE NW
SEATTLE WA
98107-2270
US

V. Phone/Fax

Practice location:
  • Phone: 206-784-3494
  • Fax: 206-789-2088
Mailing address:
  • Phone: 206-784-3494
  • Fax: 206-789-2088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH0034506
License Number StateWA

VIII. Authorized Official

Name: DEE HOATS
Title or Position: OWNER/MANAGER
Credential:
Phone: 206-784-3494