MEDICARE: DR. DONALD SCOTT BENNETT 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
1	111N00000X	Chiropractor	8091	TX
2	111N00000X	Chiropractor	CH60424718	WA

General Provider Information

NPI Number	:	1831126960
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD SCOTT BENNETT D.C.

Provider Business Mailing Address
First Line	:	4518 147TH PL SE
Second Line	:
City	:	MILL CREEK
State	:	WA
Zip	:	98012-4753
Country	:	US
Telephone Number	:	832-496-4881
Fax Number	:	425-836-5250

Provider Business Practice Location Address
First Line	:	460 228TH AVE NE
Second Line	:
City	:	SAMMAMISH
State	:	WA
Zip	:	98074-7209
Country	:	US
Telephone Number	:	425-868-9025
Fax Number	:	425-836-5250

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2006
Last Update Date	:	10/19/2015

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