Healthcare Provider Details

I. General information

NPI: 1780207241
Provider Name (Legal Business Name): BALLARD SEATTLE CHIROPRACTIC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2020
Last Update Date: 03/14/2022
Certification Date: 03/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5429 RUSSELL AVE NW STE 300
SEATTLE WA
98107-4010
US

IV. Provider business mailing address

601 S PINE ST STE 201
TACOMA WA
98405-2795
US

V. Phone/Fax

Practice location:
  • Phone: 206-783-6000
  • Fax:
Mailing address:
  • Phone: 253-396-1000
  • Fax:

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: DR. BRADLEY DAVID EYFORD
Title or Position: DOCTOR/OWNER
Credential: DC
Phone: 253-396-1000