Healthcare Provider Details

I. General information

NPI: 1720111875
Provider Name (Legal Business Name): TCC INC PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 07/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

557 ROY ST SUITE 100
SEATTLE WA
98109-4219
US

IV. Provider business mailing address

PO BOX 99490
SEATTLE WA
98139-0490
US

V. Phone/Fax

Practice location:
  • Phone: 206-285-1068
  • Fax: 206-285-0821
Mailing address:
  • Phone: 206-285-1068
  • Fax: 206-285-0821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1862
License Number StateWA

VIII. Authorized Official

Name: NANCY G EDWARDS
Title or Position: PRESIDENT CHIROPRACTOR
Credential: D.C.
Phone: 206-285-1068