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General NPI Number Information
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NPI Number | 1366658890
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Entity Type | Organization
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Legal Business Name | WAY OF LIFE CHIROPRACTIC PS
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 03/18/2016
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Provider Practice Location Address
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Address Line | 355 NW GILMAN BLVD STE 105
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City | ISSAQUAH
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State | WA
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Zip | 98027-2401
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Country | US
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Telephone | 425-313-0433
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Fax | 425-313-5069
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Provider Business Mailing Address
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Address Line | 355 NW GILMAN BLVD STE 105
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City | ISSAQUAH
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State | WA
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Zip | 98027-2401
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Country | US
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Telephone | 425-313-0433
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Fax | 425-313-5069
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PENELOPE SILBER
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Credential | D.C.
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Telephone | 425-313-0433
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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 | 3333
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License Number State | WA
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