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General NPI Number Information
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NPI Number | 1033283064
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Entity Type | Organization
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Legal Business Name | CRAIG D. DAHL D.C. INC. PS
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 17422 108TH AVE SE STE 102
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City | RENTON
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State | WA
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Zip | 98055-5400
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Country | US
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Telephone | 425-255-0427
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Fax |
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Provider Business Mailing Address
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Address Line | 17422 108TH AVE SE STE 102
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City | RENTON
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State | WA
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Zip | 98055-5400
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Country | US
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Telephone | 425-255-0427
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CRAIG DAVID DAHL
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Credential | D.C.
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Telephone | 253-797-4843
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH0003431
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License Number State | WA
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