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NPI Code Detail

MEDICARE: NEWPORT CHIROPRACTIC CENTER, PS.

MEDICARE: NEWPORT CHIROPRACTIC CENTER, PS.
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
1111N00000XChiropractor1551WA

General Provider Information

NPI Number : 1598836363
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEWPORT CHIROPRACTIC CENTER, PS.
Provider Business Mailing Address
First Line : 4307 FACTORIA BLVD SE
Second Line : SUITE 1
City : BELLEVUE
State : WA
Zip : 98006-1936
Country : US
Telephone Number : 425-747-5657
Fax Number : 425-747-5334
Provider Business Practice Location Address
First Line : 4307 FACTORIA BLVD SE
Second Line : SUITE 1
City : BELLEVUE
State : WA
Zip : 98006-1936
Country : US
Telephone Number : 425-747-5657
Fax Number : 425-747-5334
Authorized Official
Title or Position : PRESIDENT
Name : DR. JOHN PETER LORGE III
Credential : DC
Telephone Number : 425-747-5657
Provider Enumeration Date : 11/13/2006
Last Update Date : 08/22/2020

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Directions to “NEWPORT CHIROPRACTIC CENTER, PS. ” Practice Location

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