Healthcare Provider Details
I. General information
NPI: 1023901568
Provider Name (Legal Business Name): VIBRANT LIFE CHIROPRACTIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/02/2025
Last Update Date: 02/10/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
920 ALDER AVE STE 201
SUMNER WA
98390-1401
US
IV. Provider business mailing address
920 ALDER AVE STE 201
SUMNER WA
98390-1401
US
V. Phone/Fax
- Phone: 253-863-9695
- Fax:
- Phone: 253-863-9695
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NP0017X |
| Taxonomy | Pediatric Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
CHERIS
PARESA
Title or Position: CEO
Credential: DC
Phone: 253-863-9695