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General NPI Number Information
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NPI Number | 1588379150
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Entity Type | Individual
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Provider Name | PSACHIEN RAJINTHA HEWAWASAM
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Gender | Male
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Dates
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Enumeration Date | 01/18/2023
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Last Update Date | 01/18/2023
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Provider Practice Location Address
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Address Line | 100 WALL ST
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City | SEATTLE
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State | WA
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Zip | 98121-1423
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Country | US
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Telephone | 206-448-9407
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Fax |
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Provider Business Mailing Address
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Address Line | 1702 JUDD ST SE APT 6
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City | LACEY
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State | WA
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Zip | 98503-2706
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Country | US
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Telephone | 360-421-0762
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | CH61389659
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License Number State | WA
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