Healthcare Provider Details
I. General information
NPI: 1598846040
Provider Name (Legal Business Name): THE CHIROPRACTORS CLINIC, P.S.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/18/2006
Last Update Date: 02/12/2024
Certification Date: 01/18/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3595 NW BUCKIN HILL RD
SILVERDALE WA
98383-8503
US
IV. Provider business mailing address
PO BOX 483
SILVERDALE WA
98383
US
V. Phone/Fax
- Phone: 360-698-3140
- Fax: 360-692-1441
- Phone: 360-698-3140
- Fax: 360-692-1441
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | CH00001522 |
| License Number State | WA |
VIII. Authorized Official
Name: DR.
DAVID
W
STEDMAN
Title or Position: CLINIC DIRECTOR
Credential: D.C.
Phone: 360-698-3140