Healthcare Provider Details

I. General information

NPI: 1578747622
Provider Name (Legal Business Name): LEMBKE CHIROPRACTIC CLINIC PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2007
Last Update Date: 02/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11015 NE FOURTH PLAIN RD SUITE B
VANCOUVER WA
98662-6314
US

IV. Provider business mailing address

11015 NE FOURTH PLAIN RD SUITE B
VANCOUVER WA
98662-6314
US

V. Phone/Fax

Practice location:
  • Phone: 360-892-0451
  • Fax: 360-892-1601
Mailing address:
  • Phone: 360-892-0451
  • Fax: 360-892-1601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2025
License Number StateWA

VIII. Authorized Official

Name: DR. SCOTT DAVID LEMBKE
Title or Position: PRESIDENT
Credential: D.C.
Phone: 360-892-0451