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General NPI Number Information
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NPI Number | 1417312042
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Entity Type | Organization
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Legal Business Name | DR. JUSTIN PAQUETTE, DC
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Dates
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Enumeration Date | 12/26/2015
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Last Update Date | 12/26/2015
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Provider Practice Location Address
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Address Line | 910 LENORA ST #160
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City | SEATTLE
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State | WA
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Zip | 98121-2754
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Country | US
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Telephone | 206-397-3457
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Fax |
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Provider Business Mailing Address
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Address Line | 190 HARBOR SQ LOOP NE C328
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City | BAINBRIDGE ISLAND
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State | WA
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Zip | 98110-2453
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Country | US
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Telephone | 818-687-0867
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | JUSTIN THOMAS PAQUETTE
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Credential | D.C.
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Telephone | 818-687-0867
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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 | 60608428
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License Number State | WA
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