Healthcare Provider Details

I. General information

NPI: 1881993855
Provider Name (Legal Business Name): HULTMAN CHIROPRACTIC PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2011
Last Update Date: 05/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2611 NE 125TH ST SUITE 247
SEATTLE WA
98125-4373
US

IV. Provider business mailing address

2611 NE 125TH ST SUITE 247
SEATTLE WA
98125-4373
US

V. Phone/Fax

Practice location:
  • Phone: 206-367-5090
  • Fax:
Mailing address:
  • Phone: 206-367-5090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number60186618
License Number StateWA

VIII. Authorized Official

Name: DR. CORY HULTMAN
Title or Position: DOCTOR OF CHIROPRACTIC
Credential: D.C.
Phone: 206-367-5090