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General NPI Number Information
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NPI Number | 1417373994
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Entity Type | Organization
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Legal Business Name | SEATTLE PEDIATRIC CHIROPRACTIC, P.
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Dates
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Enumeration Date | 03/08/2014
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Last Update Date | 11/05/2014
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Provider Practice Location Address
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Address Line | 2117 WAVERLY PL N APT 4
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City | SEATTLE
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State | WA
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Zip | 98109-2421
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Country | US
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Telephone | 253-569-6931
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Fax |
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Provider Business Mailing Address
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Address Line | 2117 WAVERLY PL N APT 4
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City | SEATTLE
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State | WA
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Zip | 98109-2421
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Country | US
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Telephone | 253-569-6931
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEPHANIE L SMITH
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Credential | DC
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Telephone | 253-569-6931
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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 | CH 60427167
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License Number State | WA
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