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General NPI Number Information
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NPI Number | 1942729462
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Entity Type | Organization
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Legal Business Name | IAN CONGDON, SEATTLE CHIROPRACTOR
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Dates
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Enumeration Date | 09/15/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 10212 5TH AVE NE STE 120
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City | SEATTLE
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State | WA
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Zip | 98125-7471
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Country | US
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Telephone | 206-641-7707
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Fax | 206-641-7709
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Provider Business Mailing Address
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Address Line | 10212 5TH AVE NE STE 120
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City | SEATTLE
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State | WA
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Zip | 98125-7471
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Country | US
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Telephone | 206-641-7707
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Fax | 206-641-7709
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Authorized Official
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Title or Position | OWNER
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Name | DR. IAN RHETT CONGDON
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Credential | DC
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Telephone | 206-641-7707
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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 | CH60115439
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License Number State | WA
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