1942951132 NPI number — ACCIDENT CARE CHIROPRACT AND MASSAGE OF EAST VANCOUVER

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 1942951132 NPI number — ACCIDENT CARE CHIROPRACT AND MASSAGE OF EAST VANCOUVER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACCIDENT CARE CHIROPRACT AND MASSAGE OF EAST VANCOUVER
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:
1942951132
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/10/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14930 SE MILL PLAIN BLVD STE 106
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VANCOUVER
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98684-8298
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-718-8689
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14930 SE MILL PLAIN BLVD STE 106
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VANCOUVER
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98684-8298
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-718-8689
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/10/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
NGUYEN
Authorized Official First Name:
LINDA
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIROPRACTOR
Authorized Official Telephone Number:
360-718-8689

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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