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NPI Code Detail

MEDICARE: JAMES TODD FREDERICK D.C.

MEDICARE:   JAMES TODD FREDERICK  D.C.
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
1111N00000XChiropractor2971WA

General Provider Information

NPI Number : 1801910443
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES TODD FREDERICK D.C.
Provider Business Mailing Address
First Line : 8040 128TH LN SE
Second Line :
City : NEWCASTLE
State : WA
Zip : 98056-1798
Country : US
Telephone Number : 425-227-6575
Fax Number :
Provider Business Practice Location Address
First Line : 4739 RAINIER AVE S
Second Line :
City : SEATTLE
State : WA
Zip : 98118-1657
Country : US
Telephone Number : 206-721-1827
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2007
Last Update Date : 07/08/2007

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Directions to “ JAMES TODD FREDERICK D.C.” Practice Location

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