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General NPI Number Information
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NPI Number | 1750666434
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Entity Type | Individual
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Provider Name | JASON KYLE HONTZ D.C.
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Gender | Male
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Dates
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Enumeration Date | 10/13/2011
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Last Update Date | 08/05/2020
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Provider Practice Location Address
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Address Line | 11314 4TH AVE W STE 103
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City | EVERETT
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State | WA
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Zip | 98204-6926
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Country | US
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Telephone | 425-355-3739
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Fax | 425-514-8353
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Provider Business Mailing Address
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Address Line | 55 NW WALL ST STE 100
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City | BEND
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State | OR
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Zip | 97703-3200
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Country | US
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Telephone | 541-389-4321
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Fax | 541-389-4420
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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 | CH60238068
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License Number State | WA
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