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General NPI Number Information
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NPI Number | 1932460896
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Entity Type | Organization
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Legal Business Name | ADVANCED WELLNESS AND REHABILITATION PLLC
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Dates
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Enumeration Date | 06/06/2012
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Last Update Date | 11/21/2017
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Provider Practice Location Address
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Address Line | 10513 SILVERDALE WAY STE 102
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City | SILVERDALE
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State | WA
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Zip | 98383-9499
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Country | US
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Telephone | 360-698-4411
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Fax | 360-698-6953
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Provider Business Mailing Address
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Address Line | 10513 SILVERDALE WAY STE 102
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City | SILVERDALE
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State | WA
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Zip | 98383-9499
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Country | US
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Telephone | 360-698-4411
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Fax | 360-698-6953
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. DARLENE S WILLIAMS
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Credential |
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Telephone | 360-698-4411
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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 | 025202CH00003462
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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 | CH00034705
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH00002820
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 60138481
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License Number State | WA
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Taxonomy #5
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC00002719
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License Number State | WA
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Taxonomy #6
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA00015277
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License Number State | WA
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Taxonomy #7
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA60182495
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License Number State | WA
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Taxonomy #8
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 603120987
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License Number State | WA
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Taxonomy #9
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA60253849
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License Number State | WA
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Taxonomy #10
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH00003462
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License Number State | WA
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