1568568848 NPI number — DARLING CHIROPRACTIC SERVICES, PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568568848 NPI number — DARLING CHIROPRACTIC SERVICES, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DARLING CHIROPRACTIC SERVICES, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CAMAS FAMILY HEALTH CENTER, PC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568568848
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/25/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
235 NE 6TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAMAS
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98607-2033
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-834-5126
Provider Business Mailing Address Fax Number:
360-834-5126

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
235 NE 6TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAMAS
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98607-2033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-834-5126
Provider Business Practice Location Address Fax Number:
360-834-5126
Provider Enumeration Date:
09/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DARLING
Authorized Official First Name:
TRISTA
Authorized Official Middle Name:
LYNN
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
360-834-5126

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  CH00034505 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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