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General NPI Number Information
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NPI Number | 1922235415
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Entity Type | Organization
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Legal Business Name | LAKE UNION CHIROPRACTIC CLINIC, PLLC
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Dates
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Enumeration Date | 06/11/2009
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Last Update Date | 06/11/2009
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Provider Practice Location Address
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Address Line | 235 WESTLAKE AVE N
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City | SEATTLE
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State | WA
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Zip | 98109-5217
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Country | US
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Telephone | 206-749-5253
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Fax |
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Provider Business Mailing Address
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Address Line | 235 WESTLAKE AVE N
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City | SEATTLE
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State | WA
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Zip | 98109-5217
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Country | US
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Telephone | 206-749-5253
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TED R STEFFEN
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Credential | DC
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Telephone | 206-245-9637
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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 | 33706
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License Number State | WA
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