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General NPI Number Information
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NPI Number | 1043726615
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Entity Type | Organization
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Legal Business Name | MATTHEW WALDRON DC
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Dates
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Enumeration Date | 12/19/2017
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Last Update Date | 12/19/2017
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Provider Practice Location Address
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Address Line | 23009 56TH AVE W STE B
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City | MOUNTLAKE TERRACE
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State | WA
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Zip | 98043-4713
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Country | US
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Telephone | 425-778-9600
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Fax | 425-332-7018
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Provider Business Mailing Address
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Address Line | 23009 56TH AVE W STE B
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City | MOUNTLAKE TERRACE
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State | WA
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Zip | 98043-4713
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Country | US
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Telephone | 425-778-9600
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Fax | 425-332-7018
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Authorized Official
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Title or Position | OWNER
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Name | DR. MATTHEW KEVIN WALDRON
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Credential | DC
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Telephone | 425-778-9600
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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 | CH00003315
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License Number State | WA
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