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General NPI Number Information
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NPI Number | 1598281768
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Entity Type | Organization
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Legal Business Name | WESTSIDE SPINE PS
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Dates
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Enumeration Date | 08/18/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 6850 35TH AVE NE STE 9
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City | SEATTLE
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State | WA
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Zip | 98115-7344
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Country | US
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Telephone | 206-524-3003
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Fax | 206-527-8998
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Provider Business Mailing Address
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Address Line | 6850 35TH AVE NE STE 9
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City | SEATTLE
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State | WA
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Zip | 98115-7344
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Country | US
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Telephone | 206-524-3003
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Fax | 206-527-8998
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | DR. LYNNA LIES
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Credential | DC
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Telephone | 206-524-3003
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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 | CH60058655
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License Number State | WA
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