Healthcare Provider Details

I. General information

NPI: 1003038977
Provider Name (Legal Business Name): MICHAEL J COVINGTON DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 06/09/2023
Certification Date: 06/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3907 CREEKSIDE LOOP STE 100
YAKIMA WA
98902-4879
US

IV. Provider business mailing address

3907 CREEKSIDE LOOP STE 100
YAKIMA WA
98902-4879
US

V. Phone/Fax

Practice location:
  • Phone: 509-895-7535
  • Fax: 509-895-7355
Mailing address:
  • Phone: 509-895-7535
  • Fax: 509-895-7355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH60022455
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License NumberCH60022455
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberCH60022455
License Number StateWA
# 4
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberCH60022455
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: