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NPI 1578296323

NPI 1578296323 : COTTRELL CHIROPRACTIC PS : ISSAQUAH, WA

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General NPI Number Information
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    NPI Number           |    1578296323
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    Entity Type          |    Organization 
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    Legal Business Name  |    COTTRELL CHIROPRACTIC PS 
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Dates
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    Enumeration Date     |    07/07/2022
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    Last Update Date     |    07/07/2022
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Provider Practice Location Address
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    Address Line         |    140 6TH AVE NE 
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    City                 |    ISSAQUAH
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    State                |    WA
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    Zip                  |    98027-3341
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    Country              |    US
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    Telephone            |    424-392-9490
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    Fax                  |    425-427-6401
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Provider Business Mailing Address
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    Address Line         |    140 6TH AVE NE 
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    City                 |    ISSAQUAH
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    State                |    WA
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    Zip                  |    98027-3341
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    Country              |    US
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    Telephone            |    424-392-9490
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    Fax                  |    425-427-6401
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Authorized Official
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    Title or Position    |    OWNER/ PRESIDENT
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    Name                 |    DR. TERRY W COTTRELL 
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    Credential           |    D.C.
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    Telephone            |    424-392-9490
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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 |    
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