MEDICARE: ROBERT ADAMS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	60930717	WA

General Provider Information

NPI Number	:	1265999221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT ADAMS

Provider Business Mailing Address
First Line	:	3837 13TH AVE W STE 208
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98119-1359
Country	:	US
Telephone Number	:	206-420-3131
Fax Number	:

Provider Business Practice Location Address
First Line	:	3837 13TH AVE W STE 208
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98119-1359
Country	:	US
Telephone Number	:	206-420-3131
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2019
Last Update Date	:	02/26/2019

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