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General NPI Number Information
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NPI Number | 1942486857
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Entity Type | Organization
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Legal Business Name | RYAN COOGAN DC PS
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Dates
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Enumeration Date | 01/10/2008
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Last Update Date | 01/27/2009
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Provider Practice Location Address
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Address Line | 11902 97TH AVE NE
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City | KIRKLAND
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State | WA
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Zip | 98034-1882
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Country | US
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Telephone | 425-821-4600
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Fax | 425-821-4622
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Provider Business Mailing Address
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Address Line | 11902 97TH AVE NE
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City | KIRKLAND
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State | WA
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Zip | 98034-1882
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Country | US
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Telephone | 425-821-4600
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Fax | 425-821-4622
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RYAN SEAN COOGAN
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Credential | DC
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Telephone | 425-821-4600
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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 | CH00034000
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License Number State | WA
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