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General NPI Number Information
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NPI Number | 1780693085
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Entity Type | Organization
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Legal Business Name | WHITE CENTER CHIROPRACTIC, PLLC
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 03/06/2008
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Provider Practice Location Address
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Address Line | 10030 15TH AVE SW
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City | SEATTLE
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State | WA
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Zip | 98146-3728
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Country | US
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Telephone | 206-763-7464
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Fax |
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Provider Business Mailing Address
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Address Line | 10030 15TH AVE SW
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City | SEATTLE
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State | WA
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Zip | 98146-3728
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Country | US
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Telephone | 206-763-7464
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Fax |
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Authorized Official
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Title or Position | MANAGER/MEMBER
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Name | DR. IAN DAVIS
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Credential | D.C.
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Telephone | 206-763-7464
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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 | CH34448
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License Number State | WA
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