1174665400 NPI number — WHITE AND ASSOCIATES LLC

Table of content: (NPI 1174665400)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174665400 NPI number — WHITE AND ASSOCIATES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WHITE AND ASSOCIATES LLC
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:
6
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:
1174665400
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15603 MAIN STREET
Provider Second Line Business Mailing Address:
SUITE 106
Provider Business Mailing Address City Name:
MILL CREEK
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98012
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-357-1105
Provider Business Mailing Address Fax Number:
425-379-9771

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15603 MAIN STREET
Provider Second Line Business Practice Location Address:
SUITE 106 SYNERGY CHIROPRACTIC
Provider Business Practice Location Address City Name:
MILL CREEK
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98012
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-357-1105
Provider Business Practice Location Address Fax Number:
425-379-9771
Provider Enumeration Date:
02/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
WHITE
Authorized Official First Name:
DARREN
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OFFICER
Authorized Official Telephone Number:
425-820-8837

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 225700000X , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: 0194783 . This is a "LABOR & INDUSTRY" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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