Healthcare Provider Details

I. General information

NPI: 1912833401
Provider Name (Legal Business Name): TUCKER NOEL DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9425 N NEVADA ST STE 104
SPOKANE WA
99218-1294
US

IV. Provider business mailing address

9425 N NEVADA ST STE 104
SPOKANE WA
99218-1294
US

V. Phone/Fax

Practice location:
  • Phone: 509-355-1943
  • Fax:
Mailing address:
  • Phone: 509-355-1943
  • Fax: 509-984-4570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIR.CH61671827
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: