Healthcare Provider Details

I. General information

NPI: 1609973676
Provider Name (Legal Business Name): RAYNEL J HUNT D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 MAIN ST
WASHOUGAL WA
98671-4116
US

IV. Provider business mailing address

PO BOX 246
WASHOUGAL WA
98671-0246
US

V. Phone/Fax

Practice location:
  • Phone: 360-835-3150
  • Fax: 360-835-0459
Mailing address:
  • Phone: 360-835-3150
  • Fax: 360-835-0459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH 60096097
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: