=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619568771
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CALIBRATE CHIROPRACTIC, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/01/2021
-----------------------------------------------------
Last Update Date | 10/30/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 24000 VAN RY BLVD STE 108
-----------------------------------------------------
City | MOUNTLAKE TERRACE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98043-5461
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 425-678-9977
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3924 243RD PL SE UNIT G202
-----------------------------------------------------
City | BOTHELL
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98021-6928
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIROPRACTOR
-----------------------------------------------------
Name | DR. ROBERT CHANT II
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 253-548-5829
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------