Healthcare Provider Details

I. General information

NPI: 1861632713
Provider Name (Legal Business Name): DR SEAN SPAULDING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2009
Last Update Date: 03/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 N MONTESANO ST
WESTPORT WA
98595
US

IV. Provider business mailing address

PO BOX 2417
WESTPORT WA
98595-2417
US

V. Phone/Fax

Practice location:
  • Phone: 360-268-1603
  • Fax:
Mailing address:
  • Phone: 360-268-1603
  • Fax: 360-268-1683

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. SEAN SPAULDING
Title or Position: OWNER
Credential: D.C. C.S.C.S
Phone: 360-268-1603