MEDICARE: IAN WILLIAMS PLLC

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	CH00003453	WA
2	111N00000X	Chiropractor	CH60196649	WA
3	111N00000X	Chiropractor	CH60231990	WA

General Provider Information

NPI Number	:	1568912970
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IAN WILLIAMS PLLC

Provider Business Mailing Address
First Line	:	410 BELLEVUE WAY SE STE 202
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98004-6649
Country	:	US
Telephone Number	:	425-378-1800
Fax Number	:	425-462-1802

Provider Business Practice Location Address
First Line	:	410 BELLEVUE WAY SE STE 202
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98004-6649
Country	:	US
Telephone Number	:	425-378-1800
Fax Number	:	425-462-1802

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ROBERT IAN WILLIAMS
Credential	:	DC
Telephone Number	:	425-378-1800

Provider Enumeration Date	:	10/10/2016
Last Update Date	:	10/10/2016

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