1942539739 NPI number — FRANKLIN CHIROPRACTIC PS

Table of content: BILAL JAMIL MOHAMMAD ALBTOUSH (NPI 1275146243)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942539739 NPI number — FRANKLIN CHIROPRACTIC PS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FRANKLIN CHIROPRACTIC PS
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:
Provider Other Organization Name Type Code:
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:
1942539739
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/03/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10030 SILVERDALE WAY NW STE 102
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SILVERDALE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98383-7624
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-516-6989
Provider Business Mailing Address Fax Number:
360-799-5624

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10030 SILVERDALE WAY NW STE 102
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SILVERDALE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98383-7624
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-516-6989
Provider Business Practice Location Address Fax Number:
360-799-5624
Provider Enumeration Date:
12/08/2009

Additional Information

Authorized Official

Authorized Official Last Name:
VECHABUT
Authorized Official First Name:
FLORENCE
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
360-516-6989

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  CH6012674 , 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: CH6012674 . This is a "WA STATE BUSINESS LICENSE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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