Healthcare Provider Details

I. General information

NPI: 1841087228
Provider Name (Legal Business Name): NORTHWEST SPINE & INJURY CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2025
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15803 PACIFIC AVE S STE C
TACOMA WA
98444-6963
US

IV. Provider business mailing address

6520 86TH AVE W
UNIVERSITY PLACE WA
98467-4066
US

V. Phone/Fax

Practice location:
  • Phone: 253-220-3531
  • Fax: 253-581-2444
Mailing address:
  • Phone: 425-545-5644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: JASON OH
Title or Position: OWNER/CHIROPRACTOR
Credential: DC
Phone: 206-960-3344