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General NPI Number Information
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NPI Number | 1922291699
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Entity Type | Organization
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Legal Business Name | DEVINE CHIROPRACTIC AND REHAB CENTER
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Dates
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Enumeration Date | 08/24/2007
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Last Update Date | 07/06/2016
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Provider Practice Location Address
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Address Line | 104 PIKE ST SUITE 210
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City | SEATTLE
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State | WA
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Zip | 98101-2010
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Country | US
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Telephone | 206-623-2225
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Fax | 206-686-7246
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Provider Business Mailing Address
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Address Line | 104 PIKE ST SUITE 210
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City | SEATTLE
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State | WA
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Zip | 98101-2010
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Country | US
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Telephone | 206-623-2225
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Fax | 206-686-7246
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Authorized Official
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Title or Position | OWNER
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Name | JAMES A DEVINE
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Credential | D.C.
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Telephone | 206-623-2225
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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 | CH00002518
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License Number State | WA
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