MEDICARE: BLAND APPLIED KINESIOLOGY AND CHIROPRACTIC CLINIC 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

General Provider Information

NPI Number	:	1710632641
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLAND APPLIED KINESIOLOGY AND CHIROPRACTIC CLINIC PLLC

Provider Business Mailing Address
First Line	:	1019 REGENTS BLVD STE 203
Second Line	:
City	:	FIRCREST
State	:	WA
Zip	:	98466-6037
Country	:	US
Telephone Number	:	253-302-3131
Fax Number	:

Provider Business Practice Location Address
First Line	:	1019 REGENTS BLVD STE 203
Second Line	:
City	:	FIRCREST
State	:	WA
Zip	:	98466-6037
Country	:	US
Telephone Number	:	253-302-3131
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. RYAN BLAND
Credential	:	DC
Telephone Number	:	253-302-3131

Provider Enumeration Date	:	02/18/2022
Last Update Date	:	02/18/2022

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