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General NPI Number Information
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NPI Number | 1912241662
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Entity Type | Organization
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Legal Business Name | TRIFECTA PLLC
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Dates
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Enumeration Date | 11/19/2012
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Last Update Date | 11/19/2012
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Provider Practice Location Address
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Address Line | 16704 INTERNATIONAL BLVD
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City | SEATAC
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State | WA
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Zip | 98188-3116
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Country | US
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Telephone | 206-246-8830
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Fax |
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Provider Business Mailing Address
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Address Line | 16704 INTERNATIONAL BLVD
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City | SEATAC
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State | WA
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Zip | 98188-3116
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Country | US
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Telephone | 206-246-8830
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Fax |
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Authorized Official
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Title or Position | OWNER/PARTNER
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Name | BRANDON E SHUMAKER
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Credential | D.C.
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Telephone | 206-246-8830
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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 | CH60070223
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH60071763
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License Number State | WA
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