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General NPI Number Information
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NPI Number | 1508093626
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Entity Type | Organization
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Legal Business Name | CORE LIFE, PLLC
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Dates
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Enumeration Date | 06/16/2009
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Last Update Date | 11/03/2009
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Provider Practice Location Address
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Address Line | 7604 NE 5TH AVE SUITE 109
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City | VANCOUVER
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State | WA
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Zip | 98665-8200
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Country | US
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Telephone | 360-314-4380
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Fax | 360-314-4390
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Provider Business Mailing Address
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Address Line | 7604 NE 5TH AVE SUITE 109
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City | VANCOUVER
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State | WA
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Zip | 98665-8200
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Country | US
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Telephone | 360-314-4380
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Fax | 360-314-4390
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Authorized Official
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Title or Position | OWNER
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Name | AARON THOMAS GILLESPIE
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Credential | DC
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Telephone | 360-910-8910
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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 |
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License Number State | WA
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