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General NPI Number Information
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NPI Number | 1578057337
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Entity Type | Organization
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Legal Business Name | REGENERATIVE MEDICINE NORTHWEST PLLC
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Dates
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Enumeration Date | 06/15/2018
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Last Update Date | 12/23/2020
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Provider Practice Location Address
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Address Line | 1260 116TH AVE NE STE 200
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City | BELLEVUE
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State | WA
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Zip | 98004-3800
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Country | US
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Telephone | 855-438-7836
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Fax |
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Provider Business Mailing Address
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Address Line | 1260 116TH AVE NE STE 200
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City | BELLEVUE
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State | WA
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Zip | 98004-3800
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Country | US
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Telephone | 855-438-7836
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | DR. STEVEN MICHAEL TEAGUE
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Credential | CHIROPRACTOR
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Telephone | 360-481-9337
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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