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General NPI Number Information
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NPI Number | 1992653034
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Entity Type | Organization
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Legal Business Name | CLASSIC CHIROPRACTIC CLINIC, LLC
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Dates
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Enumeration Date | 03/16/2026
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Last Update Date | 03/16/2026
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Provider Practice Location Address
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Address Line | 1101 AVENUE D
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City | SNOHOMISH
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State | WA
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Zip | 98290-2083
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Country | US
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Telephone | 360-563-0209
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Fax | 360-563-0243
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Provider Business Mailing Address
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Address Line | 1101 AVENUE D STE C106
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City | SNOHOMISH
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State | WA
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Zip | 98290-2083
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Country | US
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Telephone | 360-563-0209
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Fax | 360-563-0243
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Authorized Official
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Title or Position | OWNER
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Name | DR. JASON LEWIS
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Credential | DC
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Telephone | 360-563-0209
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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 |
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License Number State |
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