=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174676621
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PEAKPERFORMANCECHIROPRACTICCENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/19/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 406 N MAIN ST
-----------------------------------------------------
City | COUPEVILLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98239-0471
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-678-5400
-----------------------------------------------------
Fax | 360-678-1576
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 471
-----------------------------------------------------
City | COUPEVILLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98239-0471
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-678-5400
-----------------------------------------------------
Fax | 360-678-1576
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PARTNER
-----------------------------------------------------
Name | DR. NATE A STEELE
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 360-678-5400
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------