MEDICARE: DR. JARED MARC KOHLER DC

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	CH00033615	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	147335	OTHER	WA	LABOR AND INDUSTRIES

General Provider Information

NPI Number	:	1528147253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JARED MARC KOHLER DC

Provider Business Mailing Address
First Line	:	2033 10TH AVE E
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98102-4105
Country	:	US
Telephone Number	:	206-860-9090
Fax Number	:	206-860-3699

Provider Business Practice Location Address
First Line	:	2033 10TH AVE E
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98102-4105
Country	:	US
Telephone Number	:	206-860-9090
Fax Number	:	206-860-3699

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

Provider Enumeration Date	:	11/03/2006
Last Update Date	:	07/08/2007

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