Healthcare Provider Details

I. General information

NPI: 1154552792
Provider Name (Legal Business Name): ABSOLUTE CHIROPRACTIC AND WELLNESS CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2009
Last Update Date: 07/30/2009
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

557 ROY ST SUITE #100
SEATTLE WA
98109-4219
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 TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number000436
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberCH 00034868
License Number StateWA

VIII. Authorized Official

Name: DR. DAWN MICHELLE SMALLWOOD
Title or Position: PRESIDENT
Credential: DC, NTP
Phone: 206-940-5341