1275715591 NPI number — AXIS HEALTH, PLLC

Table of content: (NPI 1275715591)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275715591 NPI number — AXIS HEALTH, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AXIS HEALTH, PLLC
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:
ATLAS CHIROPRACTIC HEALTH CENTER
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:
1275715591
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/09/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1401 E JEFFERSON ST
Provider Second Line Business Mailing Address:
SUITE 501
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98122-5576
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-324-2225
Provider Business Mailing Address Fax Number:
206-324-5244

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1401 E JEFFERSON ST
Provider Second Line Business Practice Location Address:
SUITE 501
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98122-5576
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-324-2225
Provider Business Practice Location Address Fax Number:
206-324-5244
Provider Enumeration Date:
11/28/2007

Additional Information

Authorized Official

Authorized Official Last Name:
XIDOS
Authorized Official First Name:
APHRODITE
Authorized Official Middle Name:
CORINNE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
206-324-2225

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  CH00034123 , 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)

  • Identifier: 1558559385 . This is a "PROVIDER NPI" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 196797 . This is a "STATE LABOR & INDUSTRIES" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: MA00023886 . This is a "MASSAGE LICENSE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: U93842 . This is a "UPIN" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: CH00034123 . This is a "STATE LICENSE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: CH00102 . This is a "OFFICEALLY" identifier . This identifiers is of the category "OTHER".




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