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General NPI Number Information
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NPI Number | 1043423783
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Entity Type | Individual
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Provider Name | TERRY WILLARD COTTRELL D.C.
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Gender | Male
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 06/30/2022
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Provider Practice Location Address
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Address Line | 140 6TH AVE NE
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City | ISSAQUAH
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State | WA
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Zip | 98027-3341
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Country | US
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Telephone | 425-392-9490
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Fax | 425-427-6401
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Provider Business Mailing Address
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Address Line | 6520 226TH PL SE SUITE# 203
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City | ISSAQUAH
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State | WA
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Zip | 98027-8969
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Country | US
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Telephone | 425-392-9490
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Fax | 425-427-6401
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | CH00002014
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License Number State | WA
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