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NPI 1790793677

NPI 1790793677 : KELLI K PEARSON DC : SPOKANE VALLEY, WA

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General NPI Number Information
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    NPI Number           |    1790793677
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    Entity Type          |    Individual 
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    Provider Name        |    KELLI K PEARSON DC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/04/2006
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    Last Update Date     |    03/13/2008
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Provider Practice Location Address
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    Address Line         |    1410 NORTH MULLAN STE 200
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    City                 |    SPOKANE VALLEY
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    State                |    WA
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    Zip                  |    99206
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    Country              |    US
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    Telephone            |    509-927-8997
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    Fax                  |    509-927-3919
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Provider Business Mailing Address
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    Address Line         |    1410 NORTH MULLAN STE 200
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    City                 |    SPOKANE VALLEY
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    State                |    WA
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    Zip                  |    99206
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    Country              |    US
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    Telephone            |    509-927-8997
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    Fax                  |    509-927-3919
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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       |    CH00001827
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    License Number State |    WA
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