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General NPI Number Information
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NPI Number | 1508149097
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Entity Type | Organization
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Legal Business Name | CB CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 09/21/2011
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 2026 54TH AVE E
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City | FIFE
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State | WA
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Zip | 98424-1904
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Country | US
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Telephone | 253-922-0450
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Fax | 253-926-1720
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Provider Business Mailing Address
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Address Line | 2026 54TH AVE E
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City | FIFE
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State | WA
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Zip | 98424-1904
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Country | US
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Telephone | 253-922-0450
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Fax | 253-926-1720
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Authorized Official
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Title or Position | BILLING & CREDENTIALING MANAGER
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Name | MARICE SACOMAN
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Credential |
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Telephone | 253-777-3889
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | WA
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