MEDICARE: WEST SOUND CHIROPRACTIC, P.S.

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	CH00034029	WA

General Provider Information

NPI Number	:	1790077147
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST SOUND CHIROPRACTIC, P.S.

Provider Business Mailing Address
First Line	:	1008 BETHEL AVE STE A
Second Line	:
City	:	PORT ORCHARD
State	:	WA
Zip	:	98366-4236
Country	:	US
Telephone Number	:	360-895-7744
Fax Number	:	360-895-1166

Provider Business Practice Location Address
First Line	:	1008 BETHEL AVE STE A
Second Line	:
City	:	PORT ORCHARD
State	:	WA
Zip	:	98366-4236
Country	:	US
Telephone Number	:	360-895-7744
Fax Number	:	360-895-1166

Authorized Official
Title or Position	:	OWNER/CHIROPRACTOR
Name	:	DR. JAMES P FARRELL
Credential	:	D.C.
Telephone Number	:	360-895-7744

Provider Enumeration Date	:	05/04/2011
Last Update Date	:	05/04/2011

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Directions to “WEST SOUND CHIROPRACTIC, P.S. ” Practice Location

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