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General NPI Number Information
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NPI Number | 1932396165
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Entity Type | Organization
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Legal Business Name | BTH CHIROPRACTIC & MASSAGE @ FISHER'S LANDING, PC
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Dates
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Enumeration Date | 10/02/2007
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Last Update Date | 10/02/2007
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Provider Practice Location Address
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Address Line | 16111 SE MCGILLIVRAY BLVD STE A
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City | VANCOUVER
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State | WA
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Zip | 98683-9033
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Country | US
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Telephone | 360-254-0994
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Fax | 360-254-0930
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Provider Business Mailing Address
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Address Line | 16111 SE MCGILLIVRAY BLVD. STE A
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City | VANCOUVER
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State | WA
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Zip | 98683
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Country | US
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Telephone | 360-254-0994
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Fax | 360-254-0930
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Authorized Official
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Title or Position | DC/ OWNER
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Name | MR. TOM SAEMAN
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Credential | DC
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Telephone | 360-254-0994
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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 | CH00034526
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License Number State | WA
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