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General NPI Number Information
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NPI Number | 1699229385
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Entity Type | Organization
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Legal Business Name | TRILOGY CHRIOPRACTIC
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Dates
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Enumeration Date | 08/10/2016
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Last Update Date | 08/10/2016
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Provider Practice Location Address
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Address Line | 3933 STONE WAY N
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City | SEATTLE
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State | WA
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Zip | 98103-8017
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Country | US
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Telephone | 619-248-5430
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Fax |
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Provider Business Mailing Address
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Address Line | 5514 11TH AVE NE
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City | SEATTLE
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State | WA
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Zip | 98105-3504
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | CHRISTIANA MAIA
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Credential |
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Telephone | 619-248-5430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA60686790
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License Number State | WA
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