Healthcare Provider Details

I. General information

NPI: 1710225354
Provider Name (Legal Business Name): COREY G HAHN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2013
Last Update Date: 01/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2508 W NOB HILL BLVD
YAKIMA WA
98902-5104
US

IV. Provider business mailing address

5200 W NOB HILL BLVD APT #356
YAKIMA WA
98908-3778
US

V. Phone/Fax

Practice location:
  • Phone: 509-248-5555
  • Fax:
Mailing address:
  • Phone: 570-815-5847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIR.CH.60329255
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: