Healthcare Provider Details

I. General information

NPI: 1629518907
Provider Name (Legal Business Name): PAQUETTE CHIROPRACTIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2017
Last Update Date: 03/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 NW BUCKLIN HILL RD SUITE 105
SILVERDALE WA
98383-8358
US

IV. Provider business mailing address

3100 NW BUCKLIN HILL RD SUITE 105
SILVERDALE WA
98383-8358
US

V. Phone/Fax

Practice location:
  • Phone: 360-830-6596
  • Fax:
Mailing address:
  • Phone: 360-830-6596
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number60608428
License Number StateWA

VIII. Authorized Official

Name: DR. JUSTIN PAQUETTE
Title or Position: OWNER/CHIROPRACTOR
Credential: D.C.
Phone: 818-687-0867