MEDICARE: MEADOWS FAMILY CHIROPRACTIC INC.

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	602179571	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0159352	OTHER	WA	GROUP L&I NUMBER

General Provider Information

NPI Number	:	1962572446
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEADOWS FAMILY CHIROPRACTIC INC.

Provider Business Mailing Address
First Line	:	13325 100TH AVE NE STE C&D
Second Line	:
City	:	KIRKLAND
State	:	WA
Zip	:	98034-5213
Country	:	US
Telephone Number	:	425-814-9644
Fax Number	:	425-814-7395

Provider Business Practice Location Address
First Line	:	13325 100TH AVE NE STE C&D
Second Line	:
City	:	KIRKLAND
State	:	WA
Zip	:	98034-5213
Country	:	US
Telephone Number	:	425-814-9644
Fax Number	:	425-814-7395

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JEREMY MEADOWS
Credential	:
Telephone Number	:	425-814-9644

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	02/03/2024

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