Healthcare Provider Details

I. General information

NPI: 1124360201
Provider Name (Legal Business Name): PEARL CHIROPRACTIC, P S
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2013
Last Update Date: 05/20/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7025 27TH ST W STE 1
UNIVERSITY PLACE WA
98466-5221
US

IV. Provider business mailing address

7025 27TH ST W
UNIVERSITY PLACE WA
98466-5221
US

V. Phone/Fax

Practice location:
  • Phone: 253-970-5077
  • Fax: 253-327-1296
Mailing address:
  • Phone: 253-970-5077
  • Fax: 253-327-1296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KEENA C BERNDT-MORROW
Title or Position: OWNER
Credential: D.C.
Phone: 253-970-5077