Healthcare Provider Details

I. General information

NPI: 1740529304
Provider Name (Legal Business Name): OBJECTIVE DIAGNOSTICS RESERACH & REHABILITATION INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2013
Last Update Date: 02/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6720 EASTSIDE DR NE STE 2
TACOMA WA
98422-1174
US

IV. Provider business mailing address

6720 EASTSIDE DR NE STE 2
TACOMA WA
98422-1174
US

V. Phone/Fax

Practice location:
  • Phone: 253-927-2250
  • Fax: 253-927-9221
Mailing address:
  • Phone: 253-927-2250
  • Fax: 253-927-9221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0200X
TaxonomyRadiology Chiropractor
License NumberCH00002013
License Number StateWA

VIII. Authorized Official

Name: DR. DON L FINLAYSON
Title or Position: VICE PRESIDENT
Credential: D.C.
Phone: 253-927-2250